She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie ultimately gave in. “I have to get out of here. 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 was compelled to leave to get high again. She thought she still had several weeks to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
Five days later, on 12 November 2022, Stephanie had a daughter weighing just over four pounds – premature, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt without value, criticizing herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her recover only led to increased guilt and self-harm, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to tubes and leads, so little she thought she would harm her. Embracing her at last, she felt nothing. “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.
Following a brief period she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a innovative treatment home where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a small, growing network of centers like this facility is showing an important truth: when mothers and babies stay together, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in detox, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still was concerned that child services would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in 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.”
Life on the streets, she said, was about getting by. Addiction 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 cause pain. She did not know how to love herself, much less anyone else.
Each day, staff from the center transported her to a treatment center, given as medication. Over time, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. A support specialist, a peer support specialist, visited with her own family in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” 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 bobble on her head, sitting on the wooden floor with the exit nearby. She is lean. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her leg for the children to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The parents responded that the fathers had obligations, 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. They will know they are valued.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could parent.”
Tools for treating infants affected by substances have been available for years.
The assessment tool was established in 1975|