She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the medical facility after her infection worsened up her legs. Without a job or home, estranged from her family, she lived in a shed she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had only a brief window 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 nurse had other ideas. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, 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 be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts 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 commonly used in substance abuse treatment.
A short time later, on the 12th of November, Stephanie had a infant weighing 4lb 8oz – early, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her epidural had failed, her last dose of fentanyl had been provided a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt worthless, blaming herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her source would not provide to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her recover only led to increased guilt 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 finally saw her her, she was attached to medical equipment, so small she thought she would harm her. Embracing her at last, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is demonstrating a key fact: when families are kept intact, results get better, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She left the medical center still in detox, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still was concerned that authorities would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Substances came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to cause pain. She was unable to value herself, let alone anyone else.
Every day, staff from the facility transported her to a treatment center, provided orally. Over time, she was embracing sobriety.
She spent every minute 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 intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, visited with her own five kids 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 small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a bobble on her head, resting on the floor 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 other kids to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was created in 1975|