Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the hospital emergency room after her infection worsened up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had built in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had a month remaining to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie had a infant weighing a small weight – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been provided shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she was unsuccessful. She felt without value, blaming herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her quit only led to increased guilt and negative self-talk, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The baby was taken to the NICU. When Stephanie eventually visited her, she was hooked up to monitors, so little she thought she would break her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is proving a simple point: when families are kept intact, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, care providers came to pick her up.
She departed the institution still in withdrawal, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still was concerned that authorities would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could arrive and take her baby away.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to cause pain. She lacked the ability to care for herself, let alone anyone else.
Daily, staff from the facility took her to a recovery program, administered in pill form. Over time, she was embracing sobriety.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an occupational therapist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own children in tow to drop off cookies. They all assembled beside 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 overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a decoration on her head, seated on the ground with the exit nearby. She is slender. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the other kids to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could be a mom.”
Approaches for managing infants affected by substances have been used for a long time.
The evaluation method was established in 1975|
