A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie visited the ER after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had several weeks to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
A short time later, on the 12th of November, Stephanie had a infant weighing a small weight – early, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her source declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her love for her baby would make her quit only led to deeper self-loathing and self-harm, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was hooked up to medical equipment, so little she thought she would break her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, care providers came to pick her up.
She stepped out of the hospital still in detox, fearful and unsure about what would follow.
At the facility, Stephanie still feared that authorities would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could arrive and remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about getting by. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to let her down. She did not know how to love herself, not to mention anyone else.
Daily, staff from the center transported her to a clinic for methadone, provided orally. Slowly, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. A support specialist, a mentor, visited with her own children in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a beanie with a decoration on her head, seated on the ground with the door behind her. She is slender. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the other kids to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.”
Approaches for managing infants affected by substances have existed for decades.
The Finnegan NAS scale was developed in 1975|
