She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
She encouraged 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 transitioned to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
After five days, on the 12th of November, Stephanie delivered a baby girl weighing 4lb 8oz – early, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been given a few hours prior to birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An doctor 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 pervasive expectation that her bond with her newborn would make her stop using only led to deeper self-loathing and self-abuse, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the special care nursery. When Stephanie at last met her, she was attached to medical equipment, so tiny she thought she would break her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a limited but expanding group 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 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 come next.
At Maddie’s Place, Stephanie still was concerned that authorities would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any point, someone could arrive and remove her child.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; trust 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 the facility took her to a treatment center, administered in pill form. Slowly, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an professional – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, visited with her own five kids in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby 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 black pants and a hoodie, a cap with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her posture is humble so you do not see her expression. She is presenting her daughter on her leg for the other kids to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I could parent.”
Methods to address infants affected by substances have been used for a long time.
The evaluation method was created in 1975|
