A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.

Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the ER after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had assembled in a companion's property. She was also hooked on fentanyl.

As medical staff managed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and vomited.

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

She had taken the drug before seeking medical help and had only a brief window to get treated before she needed to go home to use once more. She thought she still had a month remaining to find a way to become sober and deliver her child.

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

“I am leaving,” Stephanie said.

But the hospital refused to discharge her: the condition in her limbs was serious, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.

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 transitioned to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.

After five days, on 12 November 2022, Stephanie had a daughter weighing 4lb 8oz – premature, tiny yet healthy.

When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her epidural had failed, her final administration of fentanyl had been given four hours before delivery.

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

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

“However, I failed,” she said. “I required assistance.”

The common assumption that her bond with her newborn would make her quit only led to greater shame and self-abuse, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.

The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.

Following a brief period she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.

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

In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, custody cases decrease and future expenses reduce.

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 pick her up.

She stepped out of the hospital still in withdrawal, anxious and doubtful about what would follow.

At Maddie’s Place, Stephanie still was concerned that authorities would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could walk in and remove her child.

For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”

Life on the streets, she said, was about survival. Drugs came first; faith 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 care for herself, let alone anyone else.

Every day, staff from Maddie’s Place took her to a clinic for methadone, administered in pill form. Over time, she was beginning recovery.

She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.

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

One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, visited with her own children in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.

The children were wide-eyed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”

She has an image of the moment. She is clad in black pants and a hoodie, a cap with a bobble on her head, seated on the ground with the entryway at her back. She is lean. Her face is downcast so you miss her features. She is presenting her daughter on her lap for the other kids to see and they are crowding near, admiring and touching to the baby.

One child, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there given the chance.

“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”

Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”

Tools for treating babies with exposure have been available for years.

The Finnegan NAS scale was developed in 1975|