A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.

Pregnant and experiencing intense discomfort, a woman named Stephanie went to the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also addicted to fentanyl.

As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and vomited.

Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”

She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had four weeks left to find a way to become sober and deliver her child.

The attending nurse disagreed. She told Stephanie she was not allowed to leave.

“I am leaving,” Stephanie said.

But the hospital refused to discharge her: the infection in her legs was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.

Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in addiction recovery.

After five days, on the 12th of November, Stephanie gave birth to a infant weighing 4lb 8oz – early, tiny yet healthy.

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

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

Stephanie had sought recovery multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, berating herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her source declined to supply to her when she became visibly pregnant.

“But I couldn’t,” she said. “I had to seek support.”

The pervasive expectation that her bond with her newborn would make her recover only led to deeper self-loathing and negative self-talk, a impetus for her to relapse. Yet she could not just wish 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 at last met her, she was connected to medical equipment, so tiny she thought she would harm her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘What is our future?’” 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 professional who provided support to her.

Medical personnel told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.

In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is proving a simple point: when families are kept intact, outcomes improve, foster placements fall and overall savings increase.

It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.

She departed the institution still in detox, fearful and unsure about what would happen next.

At the facility, Stephanie still feared that child services would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and separate them.

For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”

Survival outdoors, she said, was about getting by. Addiction came first; faith came last.

Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to cause pain. She was unable to value herself, not to mention anyone else.

Daily, staff from the facility drove her to a recovery program, provided orally. Gradually, she was embracing sobriety.

She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an professional – all common issues for babies exposed to substances.

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

During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own children in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.

The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”

She holds a picture of the moment. She is dressed in black pants and a hoodie, a beanie with a pompom on her head, seated on the ground with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is presenting her daughter on her knee for the children to see and they are standing close, showing interest to the baby.

One child, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there given the chance.

“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”

Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.”

Tools for treating drug-exposed newborns have existed for decades.

The Finnegan NAS scale was created in 1975|