Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.

Pregnant and experiencing intense discomfort, a woman named Stephanie went to the ER after an infection began spreading up her legs. Jobless and without shelter, 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 physicians addressed her infection, she began to panic. The onset of withdrawal began. She slumped forward and became sick.

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

She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to use once more. She thought she still had a month remaining to find a way to become sober and deliver her child.

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

“I am leaving,” Stephanie said.

But the hospital refused to discharge her: the condition in her limbs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.

Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.

After five days, on a day in November 2022, Stephanie gave birth to a baby girl weighing a small weight – premature, small but alive.

When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given four hours before delivery.

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

Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she failed. She felt worthless, berating herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source would not provide to her when she became clearly expecting.

“However, I failed,” she said. “I needed help.”

The pervasive expectation that her bond with her newborn would make her stop using only led to greater shame and negative self-talk, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.

The newborn was transferred to the NICU. When Stephanie at last met her, she was connected to tubes and leads, so little she thought she would hurt her. Cradling her initially, she felt nothing. “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 call her daughter Izzie, after the professional who provided support to her.

Nurses and doctors told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.

In numerous states, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, recovery succeeds, foster placements fall and overall savings increase.

It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to collect her.

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

At Maddie’s Place, Stephanie still worried that CPS would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could walk in and remove her child.

For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”

Homelessness, she said, was about survival. Drugs came first; reliance came last.

Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She lacked the ability to love herself, much less anyone else.

Daily, staff from the center took her to a treatment center, provided orally. Slowly, she was embracing sobriety.

She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had increased sensitivity 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 was capable. I could be a mom.

During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. An advocate, a mentor, stopped by with her own children in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.

The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”

She has an image of the moment. She is wearing black pants and a hoodie, a gray knit hat with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you cannot see her face. She is lifting the baby on her leg for the young ones to see and they are crowding near, admiring and touching to the baby.

One child, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if possible.

“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”

Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”

Tools for treating infants affected by substances have been available for years.

The evaluation method was developed in 1975|