She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.

Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a acquaintance's garden. She was also hooked on fentanyl.

As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and vomited.

Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”

She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.

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 condition in her limbs was critical, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.

She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.

After five days, on the 12th of November, Stephanie had a daughter weighing a small weight – premature, small but alive.

When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.

She felt sick. Ill-equipped for parenting. Not fit.

Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she failed. She felt without value, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became clearly expecting.

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

The widespread belief that her bond with her newborn would make her recover only led to greater shame and negative self-talk, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.

The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would break her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.

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

Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are treated together, not apart.

In many parts of America, where a baby is found to have infant withdrawal condition regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like this facility is showing an important truth: when families are kept intact, outcomes improve, fewer children enter care and overall savings increase.

It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, care providers came to collect her.

She left the medical center still in detox, fearful and unsure about what would follow.

At Maddie’s Place, Stephanie still worried that CPS would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could walk in and take her baby away.

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

Homelessness, she said, was about survival. Substances 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 did not know how to care for herself, much less anyone else.

Daily, staff from the facility drove her to a treatment center, provided orally. Over time, she was beginning recovery.

She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an specialist – 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 would become a mother.

During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, stopped by with her own family in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.

The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”

She keeps a photo of the moment. She is clad in casual attire, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her posture is humble so you miss her features. She is holding Izzie up on her leg for the young ones to see and they are crowding near, showing interest to the baby.

Jacob, eight, asked the parents: “What about the fathers?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there if they could.

“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”

Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I would become a mother.”

Tools for treating babies with exposure have been available for years.

The evaluation method was developed in 1975|