She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.

Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.

As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and became sick.

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

She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she needed to go home to get high again. She thought she still had a month remaining to find a way to become sober and give birth.

The medical professional intervened. She told Stephanie she was staying put.

“I am leaving,” Stephanie said.

But the medical facility declined to release her: the condition in her limbs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.

She encouraged 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 medication that eases withdrawal and is commonly used in addiction recovery.

A short time later, on 12 November 2022, Stephanie delivered a daughter weighing a small weight – premature, tiny yet healthy.

When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.

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

Stephanie had sought recovery repeatedly before birth, and felt horrible each time she relapsed. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “only” 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 affection for her child would make her stop using only led to increased guilt and self-harm, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.

The newborn was transferred to the special care nursery. When Stephanie at last met her, she was connected to tubes and leads, so small she thought she would harm her. Embracing her at last, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.

Two days later she decided to name her baby after her caregiver, after the nurse who had been so kind to her.

Hospital staff told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.

In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a developing system of centers like the care home is proving a simple point: when parents and infants remain united, results get better, fewer children enter care and overall savings increase.

It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to collect her.

She left the medical center still in withdrawal, scared and uncertain about what would happen next.

At the facility, Stephanie still feared that authorities would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could enter and separate them.

For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”

Survival outdoors, she said, was about enduring. Substances 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 lacked the ability to care for herself, much less anyone else.

Every day, staff from the facility transported her to a clinic for methadone, administered in pill form. Slowly, she was beginning recovery.

She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all common issues for babies exposed to substances.

When a child recognizes these infants need affection, then I could do this. I would become a mother.

During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. A support specialist, a recovery coach, visited with her own family in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.

The children were wide-eyed in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”

She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, resting on the floor with the door behind her. She is lean. Her posture is humble so you cannot see her face. She is lifting the baby on her lap for the other kids to see and they are standing close, showing interest to the baby.

Jacob, eight, asked the parents: “What about the fathers?” The parents responded that the men were occupied, engaged elsewhere, that they would be there given the chance.

“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”

Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I found the courage. I could parent.”

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

The assessment tool was established in 1975|