She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie went to the medical facility after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had constructed in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie measured quantities 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 frequently utilized in rehabilitation.
After five days, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – born before term, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been administered shortly before she gave birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she was unsuccessful. She felt worthless, blaming herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her dealer would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her stop using only led to increased guilt and self-harm, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to medical equipment, so tiny she thought she would break her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is demonstrating a key fact: when parents and infants remain united, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still worried that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could walk in and remove her child.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to let her down. She did not know how to value herself, let alone anyone else.
Every day, staff from Maddie’s Place took her to a recovery program, given as medication. Gradually, she was starting to get clean.
She utilized each moment when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. A support specialist, a peer support specialist, stopped by with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a decoration on her head, seated on the ground with the door behind her. She is lean. Her posture is humble so you miss her features. She is holding Izzie up on her leg for the other kids to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The parents responded that the dads were busy, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could parent.”
Methods to address babies with exposure have existed for decades.
The assessment tool was created in 1975|
