Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the medical facility after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and vomited.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before coming to the ER and had just enough time to get treated before she had to return to use once more. She thought she still had several weeks to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie had a baby girl weighing 4lb 8oz – early, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her source would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her affection for her child would make her recover only led to greater shame and negative self-talk, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was hooked up to medical equipment, so little she thought she would harm her. Cradling her initially, she felt detached. “I looked 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 after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are treated together, not apart.
In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She stepped out of the hospital still in recovery, fearful and unsure about what would happen next.
At the facility, Stephanie still worried that CPS would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could enter and remove her child.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about enduring. Addiction came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She was unable to value herself, not to mention anyone else.
Daily, staff from the facility transported her to a treatment center, given as medication. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for supervised visits with their babies. A support specialist, a peer support specialist, came over with her own family in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a pompom on her head, resting on the floor with the door behind her. She is thin. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the young ones to see and they are standing close, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could parent.”
Methods to address babies with exposure have been available for years.
The evaluation method was developed in 1975|
