She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.

Eight months pregnant and in severe pain, a woman named Stephanie visited the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had assembled in a companion's property. She was also dependent on fentanyl.

As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and became sick.

Stephanie eventually collapsed. “I need to leave. 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 needed to go home to use once more. She thought she still had four weeks left to plan her recovery 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 condition in her limbs was serious, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.

Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.

Five days later, on a day in November 2022, Stephanie had a baby girl weighing 4lb 8oz – early, tiny yet healthy.

When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been administered four hours before delivery.

She felt ill. Unprepared to be a mother. Unworthy.

Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she failed. She felt without value, berating herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.

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

The common assumption that her affection for her child would make her stop using only led to greater shame and negative self-talk, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.

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

Two days later she decided to name her baby Izzie, after the nurse who had been so kind to her.

Hospital staff told her about Maddie’s Place, a new kind of care center where women and their babies are supported as a unit, not apart.

In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a developing system of centers like the care home is proving a simple point: when parents and infants remain united, recovery succeeds, custody cases decrease and overall savings increase.

It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to collect her.

She stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.

At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could walk in and separate them.

For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”

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

Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to let her down. She lacked the ability to care for herself, let alone anyone else.

Each day, staff from Maddie’s Place drove her to a treatment center, provided orally. Over time, she was beginning recovery.

She utilized each moment when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an professional – all frequent conditions for babies exposed to substances.

When a child recognizes these infants need affection, then I found the strength. I would become a mother.

On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, stopped by with her own children in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.

The children were wide-eyed in admiration 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 wearing casual attire, a gray knit hat with a decoration on her head, resting on the floor with the entryway at her back. She is slender. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her leg for the young ones to see and they are gathered around, admiring and touching to the baby.

Jacob, eight, asked the moms: “What about the fathers?” The parents responded that the men were occupied, called away to other tasks, that they would be there if possible.

“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”

Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could parent.”

Tools for treating drug-exposed newborns have been used for a long time.

The Finnegan NAS scale was created in 1975|