Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she needed to go home to use once more. She thought she still had four weeks left to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
After five days, on a day in November 2022, Stephanie delivered a infant weighing just over four pounds – premature, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her epidural had failed, her last dose of fentanyl had been given four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her source refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her stop using only led to greater shame and negative self-talk, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was hooked up to tubes and leads, so little she thought she would harm her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a small, growing network of centers like this facility is demonstrating a key fact: when mothers and babies stay together, results get better, custody cases decrease and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.
At the facility, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could enter and separate them.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Substances came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to cause pain. She was unable to value herself, let alone anyone else.
Each day, staff from Maddie’s Place drove her to a recovery program, given as medication. Over time, 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 daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, 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 deliver baked goods. They all crowded near 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 showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is wearing black pants and a hoodie, a cap with a pompom on her head, sitting on the wooden floor with the door behind her. She is lean. Her posture is humble so you cannot see her face. She is presenting her daughter 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 mothers: “What about the fathers?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could be a mom.”
Methods to address infants affected by substances have been available for years.
The evaluation method was established in 1975|
