A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.

Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room 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 friend’s yard. She was also dependent on fentanyl.

As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and became sick.

Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”

She had taken the drug before arriving at the hospital and had just enough time to get treated before she was compelled to leave to get high again. She thought she still had a month remaining to figure out how to get clean and have this baby.

The attending nurse disagreed. 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 critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.

The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.

Five days later, on the 12th of November, Stephanie gave birth to a infant weighing just over four pounds – premature, little but surviving.

When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered shortly before she gave birth.

She felt ill. Ill-equipped for parenting. Not fit.

Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she was unsuccessful. She felt without value, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became clearly expecting.

“However, I failed,” she said. “I required assistance.”

The widespread belief that her bond with her newborn would make her stop using only led to greater shame and self-abuse, a impetus 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 baby was taken to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so little she thought she would hurt her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘How will I care for 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.

Nurses and doctors told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.

In numerous states, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when parents and infants remain united, recovery succeeds, foster placements fall and overall savings increase.

It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to collect her.

She stepped out of the hospital still in recovery, scared and uncertain about what would follow.

At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could enter and separate them.

For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”

Homelessness, she said, was about getting by. Substances came first; trust came last.

Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She did not know how to care for herself, let alone anyone else.

Daily, staff from the center transported her to a recovery program, provided orally. Slowly, she was embracing sobriety.

She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support 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 increased sensitivity and required an specialist – all typical problems for babies exposed to substances.

If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.

During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. A support specialist, a peer support specialist, stopped by with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.

The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”

She has an image of the moment. She is clad in black pants and a hoodie, a gray knit hat with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her face is downcast so you miss her features. She is presenting her daughter on her lap for the other kids to see and they are crowding near, showing interest to the baby.

Jacob, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there given the chance.

“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”

Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could be a mom.”

Methods to address drug-exposed newborns have been used for a long time.

The assessment tool was developed in 1975|