A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie went to the ER after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had consumed opioids before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but medical staff detected she also had an ruptured membrane. 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 controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
After five days, on a day in November 2022, Stephanie delivered a infant weighing a small weight – born before term, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been administered shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she failed. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her affection for her child would make her recover only led to greater shame and negative self-talk, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the NICU. When Stephanie at last met her, she was attached to tubes and leads, so small she thought she would harm her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to pick her up.
She left the medical center still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could walk in and separate them.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Addiction came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to cause pain. She was unable to care for herself, let alone anyone else.
Each day, staff from the facility drove her to a treatment center, provided orally. Over time, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was receiving appropriate attention 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 typical problems for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, stopped by with her own five kids 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. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a bobble on her head, sitting on the wooden floor with the exit nearby. She is thin. Her head is tilted forward so you miss her features. She is holding Izzie up on her lap for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could be a mom.”
Approaches for managing drug-exposed newborns have existed for decades.
The assessment tool was established in 1975|
