A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Saved Them Both.

In her eighth month of pregnancy and suffering, the expectant mother went to the ER after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also hooked on fentanyl.

As medical staff managed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and became sick.

Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”

She had consumed opioids before seeking medical help and had sufficient opportunity to get treated before she had to return 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 going anywhere.

“I am leaving,” Stephanie said.

But the doctors would not let her go: the leg infection was serious, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.

The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.

Five days later, on a day in November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – born before term, tiny yet healthy.

When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been given shortly before she gave birth.

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

Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became clearly expecting.

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

The pervasive expectation that her love for her baby would make her stop using 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 will away a chronic disease.

The infant was moved to the NICU. When Stephanie at last met her, she was attached to tubes and leads, so tiny she thought she would harm her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.

After two days she decided to name her baby Izzie, after the professional who provided support 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 many parts of America, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still rushed to special care and medicated while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, foster placements fall and future expenses reduce.

It took Stephanie some time to build confidence 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 left the medical center still in detox, anxious and doubtful about what would happen next.

At the facility, Stephanie still worried that authorities would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could enter 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 enduring. Substances came first; reliance came last.

Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to let her down. She lacked the ability to value herself, not to mention anyone else.

Daily, staff from the facility transported her to a clinic for methadone, provided orally. Slowly, she was beginning recovery.

She devoted all her time outside treatment 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 feeding therapy. She also had increased sensitivity and required an professional – all typical problems for babies affected by withdrawal.

If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.

On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own five kids in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.

The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”

She has an image of the moment. She is clad in black pants and a hoodie, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her face is downcast so you miss her features. She is lifting the baby on her leg for the young ones to see and they are gathered around, showing interest to the baby.

A young boy, eight, asked the mothers: “What about the fathers?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there given the chance.

“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”

Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could be a mom.”

Tools for treating infants affected by substances have been available for years.

The Finnegan NAS scale was established in 1975|