She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie visited the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
Five days later, on the 12th of November, Stephanie had a baby girl weighing a small weight – early, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been administered shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she relapsed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her affection for her child would make her stop using only led to increased guilt and self-harm, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was attached to medical equipment, so little she thought she would hurt her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where women and their babies are treated together, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She departed the institution still in withdrawal, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still was concerned that authorities would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive and separate them.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to cause pain. She did not know how to care for herself, not to mention anyone else.
Every day, staff from Maddie’s Place drove her to a treatment center, given as medication. 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 infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her knee for the children to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the dads were busy, called away to other tasks, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I would become a mother.”
Approaches for managing babies with exposure have existed for decades.
The evaluation method was created in 1975|
