Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure 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. The onset of withdrawal began. She slumped forward and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but medical staff detected 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 controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth 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 gave birth to a baby girl weighing 4lb 8oz – early, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been given a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her source would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her stop using only led to increased guilt and negative self-talk, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate 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 little she thought she would break her. Cradling her initially, she felt detached. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like the care home is demonstrating a key fact: when mothers and babies stay together, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a while to gather the courage 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 left the medical center still in withdrawal, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could enter and separate them.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Drugs came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to hurt her. She was unable to care for herself, not to mention anyone else.
Daily, staff from the center took her to a recovery program, given as medication. Over time, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an professional – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. 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, visited with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, seated on the ground with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her lap for the other kids to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the dads were busy, 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. I will teach them about love.”
Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”
Tools for treating babies with exposure have been used for a long time.
The assessment tool was created in 1975|
