A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.

In her eighth month of pregnancy and suffering, a woman named Stephanie went to the medical facility after an infection began spreading up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had assembled in a friend’s yard. She was also hooked on fentanyl.

As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and became sick.

Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”

She had consumed opioids before arriving at the hospital and had only a brief window 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 attending nurse disagreed. She told Stephanie she was not going anywhere.

“I will go,” Stephanie said.

But the hospital refused to discharge her: the infection in her legs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.

The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.

After five days, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – premature, little but surviving.

When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her epidural had failed, her previous intake of fentanyl had been provided shortly before she gave birth.

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

Stephanie had sought recovery multiple times while expecting, and felt horrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “only” 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 widespread belief that her love for her baby would make her recover only led to increased guilt and self-harm, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.

The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.

After two days she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.

Medical personnel told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.

In numerous states, where a baby is found to have infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when families are kept intact, results get better, custody cases decrease and long-term costs decline.

It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.

She departed the institution still in withdrawal, anxious and doubtful about what would follow.

At the facility, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any time, someone could arrive and take her baby away.

For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”

Homelessness, she said, was about enduring. Addiction came first; faith came last.

Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to let her down. She did not know how to love herself, much less anyone else.

Each day, staff from the facility drove her to a clinic for methadone, provided orally. Slowly, she was beginning recovery.

She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies affected by withdrawal.

If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.

During a pre-holiday visit, Stephanie was in the common room, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.

The kids looked amazed in wonder 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 has an image of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, sitting on the wooden floor with the exit nearby. She is lean. Her face is downcast so you cannot see her face. She is holding Izzie up on her knee for the children to see and they are gathered around, admiring and touching to the baby.

A young boy, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if they could.

“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”

Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”

Methods to address infants affected by substances have been used for a long time.

The assessment tool was developed in 1975|