Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother went to the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had constructed in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had four weeks left to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts 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 often prescribed in rehabilitation.
After five days, on a day in November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – early, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been provided a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she relapsed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her quit only led to increased guilt and self-abuse, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so small she thought she would break her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition frequently, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After ensuring she qualified for the program, two staff members came to collect her.
She left the medical center still in recovery, scared and uncertain about what would come next.
At the facility, Stephanie still feared that child services would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could walk in and separate them.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to value herself, let alone anyone else.
Each day, staff from the facility took her to a recovery program, administered in pill form. Slowly, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a decoration on her head, resting on the 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 young ones to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the parents: “Why are there no men?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was established in 1975|
