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

Pregnant and experiencing intense discomfort, a woman named Stephanie visited the medical facility after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also hooked on fentanyl.

As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and became sick.

Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”

She had consumed opioids before arriving at the hospital and had just enough time 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 medical professional intervened. She told Stephanie she was not going anywhere.

“I am leaving,” Stephanie said.

But the hospital refused to discharge her: the leg infection was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.

The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.

A short time later, on 12 November 2022, Stephanie gave birth to a daughter weighing a small weight – early, small but alive.

When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her epidural had failed, her last dose of fentanyl had been provided a few hours prior to birth.

She felt unwell. Not ready for motherhood. Not fit.

Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she failed. She felt without value, berating herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her supplier declined to supply to her when she became visibly pregnant.

“However, I failed,” she said. “I required assistance.”

The common assumption that her affection for her child would make her recover only led to increased guilt and self-harm, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.

The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to monitors, so little she thought she would harm her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.

After two days she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.

Hospital staff told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.

In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, results get better, foster placements fall and overall savings increase.

It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to pick her up.

She departed the institution still in withdrawal, scared and uncertain about what would follow.

At the care center, Stephanie still worried that authorities would come seize her child – even though she was hesitant about parenting. The concern persisted: 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 was suspicious at that point.”

Survival outdoors, she said, was about survival. Drugs came first; faith came last.

Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to hurt her. She did not know how to care for herself, much less anyone else.

Every day, staff from Maddie’s Place drove her to a clinic for methadone, provided orally. Gradually, she was beginning recovery.

She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an specialist – all common issues for babies exposed to substances.

When a child recognizes these infants need affection, then I was capable. I could be a mom.

One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a recovery coach, visited with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.

The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”

She has an image 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 door behind her. She is lean. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her lap for the other kids to see and they are gathered around, fawning and reaching out to the baby.

A young boy, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if possible.

“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”

Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I would become a mother.”

Tools for treating drug-exposed newborns have been available for years.

The assessment tool was developed in 1975|