A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.

In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had constructed in a acquaintance's garden. She was also addicted to fentanyl.

As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and threw up.

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

She had used fentanyl before arriving at the hospital 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 plan her recovery and give birth.

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

“Yes, I am,” Stephanie said.

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

Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.

Five days later, on the 12th of November, Stephanie gave birth to a daughter weighing just over four pounds – born before term, tiny yet healthy.

When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided shortly before she gave birth.

She felt unwell. Unprepared to be a mother. Not fit.

Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she failed. She felt worthless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her dealer would not provide to her when she became obviously with child.

“However, I failed,” she said. “I had to seek support.”

The common assumption that her affection for her child would make her recover only led to increased guilt and self-abuse, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.

The baby was taken to the special care nursery. When Stephanie at last met her, she was connected to monitors, so little she thought she would break her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.

Following a brief period she decided to name her baby the same as her nurse, after the nurse who had been so kind to her.

Hospital staff told her about a specialized facility, a innovative treatment home where women and their babies are supported as a unit, not apart.

In many parts of America, where a baby is diagnosed with infant withdrawal condition frequently, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a small, growing network of centers like the care home is demonstrating a key fact: when parents and infants remain united, outcomes improve, fewer children enter care and future expenses reduce.

It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to collect her.

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

At the facility, Stephanie still feared that authorities would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and take her baby away.

For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”

Life on the streets, she said, was about getting by. Addiction came first; reliance came last.

Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to let her down. She was unable to love herself, much less anyone else.

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

She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an professional – all typical problems for babies affected by withdrawal.

Seeing that even a young person understands the need for care, then I could do this. I would become a mother.

On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.

The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”

She has an image of the moment. She is dressed in casual attire, a cap with a pompom on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you cannot see her face. She is lifting the baby on her lap for the young ones to see and they are standing close, fawning and reaching out to the baby.

One child, eight, asked the moms: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there given the chance.

“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”

Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could parent.”

Tools for treating babies with exposure have been used for a long time.

The Finnegan NAS scale was created in 1975|