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

Eight months pregnant and in severe pain, a woman named Stephanie visited the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had built in a friend’s yard. She was also hooked on fentanyl.

As doctors treated her infection, she began to panic. Withdrawal was setting in. She slumped forward and threw up.

Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”

She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and have this baby.

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

“I am leaving,” Stephanie said.

But the hospital refused to discharge her: the condition in her limbs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.

The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.

After five days, on the 12th of November, Stephanie had a daughter weighing a small weight – born before term, little but surviving.

When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her epidural had failed, her final administration of fentanyl had been provided four hours before delivery.

She felt unwell. Ill-equipped for parenting. Unworthy.

Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she failed. She felt hopeless, berating herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her dealer declined to supply to her when she became obviously with child.

“But I couldn’t,” she said. “I needed help.”

The pervasive expectation that her bond with her newborn would make her quit only led to greater shame and negative self-talk, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.

The infant was moved to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, so small she thought she would break her. Cradling her initially, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.

After two days she decided to call her daughter after her caregiver, after the professional who provided support to her.

Hospital staff told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.

In many parts of America, where a baby is identified with newborn addiction symptoms regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and future expenses reduce.

It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to pick her up.

She departed the institution still in withdrawal, fearful and unsure about what would follow.

At Maddie’s Place, Stephanie still feared that CPS would come take Izzie – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could walk in and take her baby away.

For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”

Life on the streets, she said, was about survival. Addiction came first; trust came last.

Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She lacked the ability to care for herself, not to mention anyone else.

Every day, staff from the facility drove her to a recovery program, administered in pill form. Gradually, she was embracing sobriety.

She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an specialist – all frequent conditions for babies born with NAS.

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

During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, visited with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.

The young ones stared in admiration of the small baby 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 holds a picture of the moment. She is dressed in casual attire, a beanie with a pompom on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you miss her features. She is holding Izzie up on her knee for the other kids to see and they are crowding near, showing interest to the baby.

A young boy, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there if they could.

“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”

Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I would become a mother.”

Methods to address babies with exposure have existed for decades.

The assessment tool was developed in 1975|