A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.

Eight months pregnant and in severe pain, the expectant mother went to the ER after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had built in a acquaintance's garden. She was also dependent on fentanyl.

As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and vomited.

Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”

She had used fentanyl before seeking medical help and had just enough time to get treated before she had to return to get high again. She thought she still had four weeks left to plan her recovery and give birth.

The medical professional intervened. She told Stephanie she was staying put.

“Yes, I am,” Stephanie said.

But the doctors would not let her go: the leg infection was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.

She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.

A short time later, on a day in November 2022, Stephanie gave birth to a daughter weighing just over four pounds – early, small but alive.

When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was emotionless. 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 sought recovery repeatedly before birth, and felt horrible each time she was unsuccessful. She felt worthless, blaming herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.

“Yet I was unable,” she said. “I had to seek support.”

The widespread belief that her affection for her child would make her recover only led to increased guilt 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 eliminate a persistent condition.

The newborn was transferred to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to medical equipment, so little she thought she would hurt her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.

After two days she decided to give her child the name Izzie, after the professional who provided support to her.

Nurses and doctors told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.

In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, outcomes improve, 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 ensuring she qualified for the program, a couple of employees came to collect her.

She stepped out of the hospital still in recovery, fearful and unsure about what would come next.

At the facility, Stephanie still was concerned that child services would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could enter and take her baby away.

For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”

Homelessness, she said, was about getting by. Drugs came first; faith came last.

Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to cause pain. She lacked the ability to value herself, let alone anyone else.

Every day, staff from Maddie’s Place drove her to a treatment center, provided orally. Gradually, she was embracing sobriety.

She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an specialist – all typical problems for babies exposed to substances.

Seeing that even a young person understands the need for care, then I could do this. I would become a mother.

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. Katie Bunch-Smith, a peer support specialist, stopped by with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.

The young ones stared in admiration of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”

She keeps a photo of the moment. She is dressed in casual attire, a gray knit hat with a decoration on her head, resting on the floor with the entryway at her back. She is thin. Her face is downcast so you cannot see her face. She is lifting the baby on her leg for the children to see and they are standing close, admiring and touching to the baby.

One child, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there given the chance.

“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”

Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I could parent.”

Approaches for managing drug-exposed newborns have been available for years.

The evaluation method was developed in 1975|