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

Eight months pregnant and in severe pain, the expectant mother went to the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had assembled in a acquaintance's garden. She was also dependent on fentanyl.

As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and became sick.

Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”

She had taken the drug before coming to the ER 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 give birth.

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

“I will go,” Stephanie said.

But the medical facility declined to release her: the condition in her limbs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.

Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.

A short time later, on a day in November 2022, Stephanie had a baby girl weighing just over four pounds – premature, small but alive.

When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given shortly before she gave birth.

She felt ill. Not ready for motherhood. Undeserving.

Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt without value, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her supplier refused to sell to her when she became visibly pregnant.

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

The pervasive expectation that her love for her baby would make her stop using only led to greater shame and self-harm, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.

The infant was moved to the special care nursery. When Stephanie at last met her, she was hooked up to tubes and leads, so little she thought she would hurt her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.

Two days later she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.

Hospital staff told her about a care center, a new kind of care center where women and their babies are treated together, not apart.

In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, outcomes improve, custody cases decrease and overall savings increase.

It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to pick her up.

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

At the facility, Stephanie still feared that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could arrive and separate them.

For the beginning period, Stephanie remained isolated. “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 getting by. Addiction came first; trust came last.

Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to let her down. She was unable to value herself, much less anyone else.

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

She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all typical problems 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 remained in the shared space, where parents in active addiction can come for supervised visits with their babies. A support specialist, a peer support specialist, visited with her own children in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.

The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”

She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a decoration on her head, resting on the floor with the door behind her. She is thin. Her posture is humble so you do not see her expression. She is holding Izzie up 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: “Why are there no men?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there if possible.

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

Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I found the courage. I would become a mother.”

Approaches for managing babies with exposure have existed for decades.

The assessment tool was developed in 1975|