She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the hospital emergency room after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
A short time later, on a day in November 2022, Stephanie had a infant weighing 4lb 8oz – premature, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was numb. Her epidural had failed, her last dose of fentanyl had been provided shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she relapsed. She felt hopeless, berating herself for not being able to overcome the challenge. An OBGYN told her to “only” stop using. Even her source would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her recover only led to increased guilt and self-abuse, a trigger for her to relapse. Yet she could not just wish 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 connected to monitors, so little she thought she would harm her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to give her child the name the same as her nurse, 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 mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is identified with newborn addiction symptoms regularly, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could arrive and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about survival. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She lacked the ability to love herself, let alone anyone else.
Each day, staff from the facility took her to a clinic for methadone, provided orally. Over time, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an specialist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. A support specialist, a peer support specialist, came over with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is dressed in casual attire, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her leg for the young ones to see and they are crowding near, showing interest to the baby.
One child, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the fathers had obligations, 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 broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I would become a mother.”
Methods to address infants affected by substances have been available for years.
The assessment tool was created in 1975|
