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, the expectant mother went to the hospital emergency room after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had built in a companion's property. She was also addicted to fentanyl.

As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and threw up.

Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”

She had used fentanyl before coming to the ER and had only a brief window to get treated before she had to return 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 staying put.

“Yes, I am,” Stephanie said.

But the medical facility declined to release her: the infection in her legs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would not survive.

The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.

Five days later, on a day in November 2022, Stephanie gave birth to a infant weighing a small weight – born before term, little but surviving.

When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her epidural had failed, her last dose of fentanyl had been administered shortly before she gave birth.

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

Stephanie had sought recovery multiple times while expecting, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her source would not provide to her when she became visibly pregnant.

“Yet I was unable,” she said. “I required assistance.”

The widespread belief that her love for her baby would make her quit only led to increased guilt and self-abuse, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.

The infant was moved to the NICU. When Stephanie finally saw her her, she was connected to tubes and leads, so small 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.

After two days she decided to name her baby the same as her nurse, after the nurse who had been so kind to her.

Medical personnel told her about a care center, a innovative treatment home where women and their babies are cared for jointly, not apart.

In much of the US, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, results get better, foster placements fall and long-term costs decline.

It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to collect her.

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

At the facility, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could walk in and take her baby away.

For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”

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

Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to cause pain. She was unable to care for herself, not to mention anyone else.

Every day, staff from the center transported her to a clinic for methadone, given as medication. Slowly, she was embracing sobriety.

She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all typical problems for babies affected by withdrawal.

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

On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. An advocate, a mentor, came over with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.

The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”

She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a bobble on her head, resting on the floor with the entryway at her back. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her lap for the children to see and they are crowding near, showing interest to the baby.

One child, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there if possible.

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

Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could be a mom.”

Methods to address drug-exposed newborns have existed for decades.

The evaluation method was established in 1975|