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

Eight months pregnant and in severe pain, the expectant mother went to the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.

As doctors treated her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and threw up.

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

She had taken the drug before arriving at the hospital and had just enough time to get treated before she had to return to get high again. She thought she still had four weeks left to figure out how to get clean and have this baby.

The attending nurse disagreed. She told Stephanie she was staying put.

“I will go,” Stephanie said.

But the hospital refused to discharge her: the leg infection was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would be at risk of death.

She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.

Five days later, on 12 November 2022, Stephanie had a baby girl weighing 4lb 8oz – premature, small but alive.

When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.

She felt ill. Unprepared to be a mother. Unworthy.

Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she failed. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her supplier refused to sell to her when she became obviously with child.

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

The widespread belief that her affection for her child would make her quit only led to deeper self-loathing and negative self-talk, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.

The baby was taken to the NICU. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.

Two days later she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.

Nurses and doctors told her about a specialized facility, a innovative treatment home where women and their babies are treated together, not apart.

In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.

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

She stepped out of the hospital still in recovery, fearful and unsure about what would happen next.

At the care center, Stephanie still was concerned that child services would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any point, someone could walk in and take her baby away.

For the first two weeks, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”

Survival outdoors, she said, was about getting by. Substances came first; trust came last.

Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to love herself, much less anyone else.

Every day, staff from the center drove her to a recovery program, administered in pill form. Gradually, she was beginning recovery.

She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an professional – all common issues for babies affected by withdrawal.

If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.

One afternoon before Thanksgiving, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. A support specialist, a peer support specialist, visited with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.

The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”

She holds a picture of the moment. She is dressed in casual attire, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her lap for the children to see and they are crowding near, showing interest to the baby.

Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, 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 the specialist made eye contact. “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 infants affected by substances have been available for years.

The assessment tool was established in 1975|