A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.

Eight months pregnant and in severe pain, the expectant mother went to the ER after an infection began spreading up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also hooked on fentanyl.

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

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

She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to figure out how to get clean and have this baby.

The nurse had other ideas. She told Stephanie she was not allowed to leave.

“Yes, I am,” Stephanie said.

But the doctors would not let her go: the leg infection was severe, but doctors had discovered she also had an amniotic fluid leak. 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 every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.

A short time later, on the 12th of November, Stephanie delivered a daughter weighing 4lb 8oz – premature, tiny yet healthy.

When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been given shortly before she gave birth.

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

Stephanie had sought recovery several times during pregnancy, and felt terrible each time she failed. She felt hopeless, blaming herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her source refused to sell to her when she became obviously with child.

“However, I failed,” she said. “I had to seek support.”

The widespread belief that her love for her baby would make her stop using only led to greater shame and self-harm, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.

The infant was moved to the NICU. When Stephanie eventually visited her, she was connected to tubes and leads, so small she thought she would break her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.

Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.

Medical personnel told her about Maddie’s Place, a innovative treatment home where women and their babies are cared for jointly, not apart.

In much of the US, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is showing an important truth: when families are kept intact, recovery succeeds, custody cases decrease and future expenses reduce.

It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.

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

At the facility, Stephanie still worried that child services would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and separate them.

For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”

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

Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to let her down. She did not know how to care for herself, let alone anyone else.

Every day, staff from Maddie’s Place took her to a recovery program, given as medication. 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 girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had sensory challenges and required an occupational therapist – all typical problems for babies born with NAS.

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

On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, visited with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet 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 holds a picture of the moment. She is clad in casual attire, a beanie with a decoration on her head, sitting on the wooden floor with the exit nearby. She is lean. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her knee for the other kids to see and they are crowding near, admiring and touching to the baby.

Jacob, eight, asked the mothers: “What about the fathers?” The parents responded that the dads were busy, engaged elsewhere, 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 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 could be a mom.”

Tools for treating babies with exposure have been used for a long time.

The assessment tool was created in 1975|