Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother visited the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had built in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had four weeks left to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
After five days, on 12 November 2022, Stephanie delivered a daughter weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her epidural had failed, her final administration of fentanyl had been given shortly before she gave birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she failed. She felt hopeless, berating herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her dealer declined to supply 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 recover only led to greater shame and negative self-talk, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was hooked up to medical equipment, so tiny she thought she would hurt her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” 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 a specialized facility, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with newborn addiction symptoms regularly, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is proving a simple point: when families are kept intact, results get better, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to collect her.
She left the medical center still in recovery, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any point, someone could enter and remove her child.
For the first two weeks, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to hurt her. She lacked the ability to value herself, much less anyone else.
Every day, staff from Maddie’s Place drove her to a treatment center, given as medication. Over time, she was embracing sobriety.
She devoted all her time outside treatment 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 pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. An advocate, a mentor, stopped by with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in casual attire, a beanie with a decoration on her head, seated on the ground with the exit nearby. She is thin. Her posture is humble so you do not see her expression. She is presenting her daughter on her lap for the young ones to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I would become a mother.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was established in 1975|
