She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the medical facility after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had built in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had used fentanyl 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 a month remaining to figure out how to get clean and give birth.
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, her nurse, 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 withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie gave birth to a baby girl weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to increased guilt and self-abuse, a impetus 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 finally saw her her, she was hooked up to tubes and leads, so tiny she thought she would break her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like this facility is showing an important truth: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
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, care providers came to bring her to the facility.
She departed the institution still in detox, fearful and unsure about what would come next.
At the care center, Stephanie still worried that authorities would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about survival. Substances came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Each day, staff from the center took her to a treatment center, given as medication. Slowly, she was beginning recovery.
She devoted all her time when not in sessions 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 feeding therapy. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. An advocate, a recovery coach, came over with her own five kids in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, seated on the ground with the entryway at her back. She is lean. Her head is tilted forward so you do not see her expression. She is lifting the baby on her knee for the children to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could be a mom.”
Methods to address infants affected by substances have existed for decades.
The evaluation method was established in 1975|
