She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.

Eight months pregnant and in severe pain, a woman named Stephanie went to the medical facility after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also hooked on fentanyl.

As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and became sick.

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

She had taken the drug before seeking medical help and had just enough time to get treated before she needed to go home to relapse. She thought she still had a month remaining to find a way to become sober and have this baby.

The medical professional intervened. She told Stephanie she was not allowed to leave.

“I am leaving,” Stephanie said.

But the doctors would not let her go: the infection in her legs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.

The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.

Five days later, on a day in November 2022, Stephanie had a daughter weighing a small weight – early, small but alive.

When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided a few hours prior to birth.

She felt sick. Unprepared to be a mother. Undeserving.

Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she failed. She felt hopeless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her source would not provide to her when she became obviously with child.

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

The common assumption that her love for her baby would make her stop using only led to greater shame and self-harm, a cause for her to return to drugs. 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 hooked up to tubes and leads, so little she thought she would hurt her. Embracing her at last, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.

Following a brief period she decided to name her baby after her caregiver, after the professional who provided support to her.

Medical personnel told her about a specialized facility, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.

In numerous states, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is proving a simple point: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.

It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to collect her.

She departed the institution still in withdrawal, scared and uncertain about what would come next.

At the care center, Stephanie still worried that CPS would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could arrive and take her baby away.

For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”

Homelessness, she said, was about survival. Addiction came first; trust came last.

Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She did not know how to value herself, let alone anyone else.

Each day, staff from the facility took her to a recovery program, given as medication. Gradually, she was starting to get clean.

She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an specialist – all frequent conditions for babies born with NAS.

When a child recognizes these infants need affection, then I found the strength. I could be a mom.

During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.

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

She keeps a photo of the moment. She is dressed in black pants and a hoodie, a beanie with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her face is downcast so you do not see her expression. She is presenting her daughter on her leg for the other kids to see and they are crowding near, admiring and touching to the baby.

Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, 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 looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.”

Approaches for managing drug-exposed newborns have been used for a long time.

The assessment tool was established in 1975|