She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.

In her eighth month of pregnancy and suffering, a woman named Stephanie arrived at the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.

As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and vomited.

Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”

She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had several weeks to plan her recovery and give birth.

The nurse had other ideas. She told Stephanie she was not allowed to leave.

“I will go,” Stephanie said.

But the hospital refused to discharge her: the leg infection was severe, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would be at risk of death.

She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.

After five days, on a day in November 2022, Stephanie gave birth to a baby girl weighing just over four pounds – premature, little but surviving.

When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been provided a few hours prior to birth.

She felt unwell. Not ready for motherhood. Unworthy.

Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she was unsuccessful. She felt worthless, blaming herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her dealer refused to sell to her when she became visibly pregnant.

“But I couldn’t,” she said. “I needed help.”

The common assumption that her bond with her newborn would make her recover only led to greater shame and self-abuse, a cause for her to use again. 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 neonatal intensive care unit. When Stephanie finally saw her her, she was connected to tubes and leads, so tiny she thought she would harm her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.

After two days 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 Maddie’s Place, a unique recovery environment where women and their babies are treated together, not apart.

In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, results get better, fewer children enter care and overall savings increase.

It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to collect her.

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

At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could enter and separate them.

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

Survival outdoors, she said, was about survival. Drugs came first; faith came last.

Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to hurt her. She lacked the ability to love herself, let alone anyone else.

Every day, staff from Maddie’s Place drove her to a clinic for methadone, given as medication. Over time, she was embracing sobriety.

She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all typical problems for babies born with NAS.

Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.

One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for guided meetings with their babies. A support specialist, a mentor, visited with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.

The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”

She keeps a photo of the moment. She is wearing casual attire, a beanie with a decoration on her head, seated on the ground with the entryway at her back. She is lean. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her leg for the other kids to see and they are crowding near, fawning and reaching out to the baby.

A young boy, eight, asked the parents: “What about the fathers?” The parents responded that the men were occupied, engaged elsewhere, that they would be there if possible.

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

Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could parent.”

Methods to address babies with exposure have existed for decades.

The assessment tool was established in 1975|