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

Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had assembled in a acquaintance's garden. She was also addicted to fentanyl.

As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.

Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”

She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had a month remaining to plan her recovery and give birth.

The nurse had other ideas. She told Stephanie she was staying put.

“Yes, I am,” Stephanie said.

But the medical facility declined to release her: the leg infection was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.

Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.

Five days later, on 12 November 2022, Stephanie delivered a daughter weighing just over four pounds – early, little but surviving.

When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her epidural had failed, her last dose of fentanyl had been given shortly before she gave birth.

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

Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt worthless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her source would not provide to her when she became clearly expecting.

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

The common assumption that her bond with her newborn would make her recover only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.

The newborn was transferred to the NICU. When Stephanie finally saw her her, she was connected to medical equipment, so little she thought she would break her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.

Two days later she decided to give her child the name the same as her nurse, after the nurse who had been so kind to her.

Hospital staff told her about a specialized facility, 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 identified with infant withdrawal condition regularly, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a developing system of centers like the care home 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 while to gather the courage to call, but she finally did. After verifying her eligibility for the program, two staff members came to pick her up.

She left the medical center still in recovery, anxious and doubtful about what would happen next.

At the facility, Stephanie still was concerned that child services would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could enter and remove her child.

For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”

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

Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to let her down. She was unable to love herself, not to mention anyone else.

Every day, staff from Maddie’s Place took her to a treatment center, given as medication. Gradually, she was starting to get clean.

She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an professional – all typical problems for babies affected by withdrawal.

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

On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a mentor, stopped by with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.

The young ones stared in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”

She has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a decoration on her head, seated on the ground with the door behind her. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.

A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the dads were busy, called away to other tasks, that they would be there if possible.

“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”

Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.”

Methods to address infants affected by substances have been available for years.

The assessment tool was created in 1975|