She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had assembled in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, 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 switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie delivered a infant weighing just over four pounds – born before term, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been provided a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she failed. She felt without value, criticizing herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The common assumption that her affection for her child would make her stop using only led to greater shame and negative self-talk, a trigger for her to relapse. 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 neonatal intensive care unit. When Stephanie at last met her, she was hooked up to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt 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.
Hospital staff told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like this facility is proving a simple point: when mothers and babies stay together, recovery succeeds, foster placements fall 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, a couple of employees came to collect her.
She stepped out of the hospital still in detox, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any point, someone could enter and separate them.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Addiction came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to let her down. She lacked the ability to care for herself, let alone anyone else.
Every day, staff from Maddie’s Place drove her to a treatment center, given as medication. Gradually, she was starting to get clean.
She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a peer support specialist, visited with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is thin. Her face is downcast so you do not see her expression. She is lifting the baby on her leg for the young ones to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the parents: “Why are there no men?” The parents responded that the men were occupied, called away to other tasks, that they would be there if they could.
“In the future,” 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. “If this little kid could see that newborns require care, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was developed in 1975|
