A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother arrived at the medical facility after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
After five days, on the 12th of November, Stephanie had a baby girl weighing a small weight – premature, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her final administration of fentanyl had been provided four hours before delivery.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she relapsed. She felt worthless, criticizing herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her source would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her stop using only led to increased guilt and self-harm, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The baby was taken to the special care nursery. When Stephanie at last met her, she was hooked up to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, results get better, 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, two staff members came to pick her up.
She left the medical center still in withdrawal, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still worried that child services would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could arrive and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to let her down. She was unable to care for herself, much less anyone else.
Each day, staff from the facility drove her to a clinic for methadone, administered in pill form. Slowly, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had sensory challenges and required an occupational therapist – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a mentor, visited with her own family in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” 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 black pants and a hoodie, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is thin. Her face is downcast so you miss her features. She is holding Izzie up on her leg for the young ones to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The moms tried to explain 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 Bunch-Smith looked at each other. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could be a mom.”
Methods to address drug-exposed newborns have existed for decades.
The assessment tool was established in 1975|
