🔗 Share this article She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both. In her eighth month of pregnancy and suffering, the expectant mother went to the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl. As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and threw up. Stephanie finally broke down. “I need to leave. I have to go home and use drugs.” She had taken the drug before coming to the ER and had only a brief window to get treated before she needed to go home to relapse. She thought she still had several weeks to find a way to become sober and have this baby. The attending nurse disagreed. She told Stephanie she was not going anywhere. “Yes, I am,” Stephanie said. But the hospital refused to discharge her: the leg infection was critical, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would not survive. She encouraged 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 treatment that reduces symptoms and is often prescribed in addiction recovery. Five days later, on the 12th of November, Stephanie gave birth to a infant weighing 4lb 8oz – early, little but surviving. When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been given shortly before she gave birth. She felt ill. Ill-equipped for parenting. Not fit. Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she failed. She felt worthless, blaming herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child. “Yet I was unable,” she said. “I required assistance.” The common assumption that her love for her baby would make her stop using only led to increased guilt and negative self-talk, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a chronic disease. The infant was moved to the special care nursery. When Stephanie at last met her, she was connected to tubes and leads, so small she thought she would hurt her. Holding her for the first time, she felt detached. “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. After two days she decided to call her daughter after her caregiver, after the nurse who had been so kind to her. Hospital staff told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart. In many parts of America, where a baby is diagnosed with newborn addiction symptoms regularly, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a small, growing network of centers like this facility is showing an important truth: when families are kept intact, outcomes improve, custody cases decrease and overall savings increase. It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to pick her up. She stepped out of the hospital still in withdrawal, scared and uncertain about what would follow. At the care center, Stephanie still was concerned that child services would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive 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.” Homelessness, she said, was about getting by. Substances came first; faith came last. Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to hurt her. She lacked the ability to care for herself, let alone anyone else. Daily, staff from the facility drove her to a recovery program, provided orally. Over time, she was beginning recovery. She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an professional – all typical problems for babies exposed to substances. If this little kid could see that these babies deserve to be loved, then I could do this. I could parent. On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a recovery coach, came over with her own children in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie. The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.” She keeps a photo of the moment. She is clad in casual attire, a gray knit hat with a bobble on her head, seated on the ground with the door behind her. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her lap for the children to see and they are gathered around, fawning and reaching out to the baby. Jacob, eight, asked the moms: “What about the fathers?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there if possible. “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 looked at each other. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could parent.” Methods to address babies with exposure have been available for years. The assessment tool was created in 1975|