A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother visited the ER after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. 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 get high.”
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 several weeks to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
After five days, on a day in November 2022, Stephanie delivered a daughter weighing 4lb 8oz – early, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was detached. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she failed. She felt without value, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her stop using only led to increased guilt and negative self-talk, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The infant was moved to the NICU. When Stephanie at last met her, she was hooked up to tubes and leads, so tiny she thought she would harm her. Holding her for the first time, 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.
After two days she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is identified 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 Maddie’s Place is showing an important truth: when families are kept intact, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She departed the institution still in recovery, fearful and unsure about what would follow.
At the care center, Stephanie still worried that child services would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could enter and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Substances came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to hurt her. She was unable to love herself, let alone anyone else.
Each day, staff from the center transported her to a recovery program, administered in pill form. Over time, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. An advocate, a mentor, came over 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 little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in casual attire, 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 holding Izzie up on her lap for the other kids to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could be a mom.”
Tools for treating infants affected by substances have been available for years.
The Finnegan NAS scale was created in 1975|
