Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.

Pregnant and experiencing intense discomfort, a woman named Stephanie visited the ER after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also dependent on fentanyl.

As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and vomited.

Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”

She had taken the drug before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to find a way to become sober and deliver her child.

The medical professional intervened. She told Stephanie she was not going anywhere.

“I am leaving,” Stephanie said.

But the medical facility declined to release 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 left, she and her baby would face grave danger.

Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.

Five days later, on the 12th of November, Stephanie delivered a daughter weighing just over four pounds – premature, tiny yet healthy.

When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been given a few hours prior to birth.

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

Stephanie had sought recovery several times during pregnancy, and felt awful each time she was unsuccessful. She felt worthless, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her supplier declined to supply to her when she became clearly expecting.

“But I couldn’t,” she said. “I required assistance.”

The widespread belief 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 return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.

The newborn was transferred to the special care nursery. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would break her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.

Following a brief period she decided to give her child the name the same as her nurse, after the nurse who had been so kind to her.

Nurses and doctors 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 diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like the care home is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, fewer children enter care and long-term costs decline.

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

She left the medical center still in recovery, scared and uncertain about what would follow.

At Maddie’s Place, Stephanie still feared that child services would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could enter and take her baby away.

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

Life on the streets, she said, was about enduring. Addiction came first; reliance came last.

Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to hurt her. She was unable to care for herself, let alone anyone else.

Each day, staff from the center took her to a recovery program, provided orally. Gradually, she was starting to get clean.

She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all common issues for babies exposed to substances.

If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.

On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a mentor, visited with her own family in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.

The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”

She has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, sitting on the wooden floor with the door behind her. She is lean. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.

Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there if they could.

“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”

Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could be a mom.”

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

The evaluation method was created in 1975|