A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also addicted to fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she had to return to relapse. She thought she still had several weeks to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
After five days, on a day in November 2022, Stephanie had a daughter weighing a small weight – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, berating herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her stop using only led to deeper self-loathing and self-abuse, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was hooked up to monitors, so little she thought she would hurt 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 after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a new kind of care center where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to collect her.
She left the medical center still in withdrawal, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could walk in and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. 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 love herself, much less anyone else.
Every day, staff from the center drove her to a clinic for methadone, provided orally. Gradually, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a mentor, visited with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing casual attire, a beanie with a decoration on her head, sitting on the wooden floor with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is lifting the baby on her knee for the other kids to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I was able. I would become a mother.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was developed in 1975|
