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

In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had assembled in a companion's property. She was also addicted to fentanyl.

As physicians addressed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and vomited.

Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”

She had taken the drug before arriving at the hospital and had only a brief window to get treated before she had to return to relapse. She thought she still had several weeks to find a way to become sober and give birth.

The attending nurse disagreed. She told Stephanie she was not allowed to leave.

“I will go,” Stephanie said.

But the hospital refused to discharge her: the infection in her legs was severe, but doctors had discovered she also had an leakage of amniotic fluid. 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 measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.

Five days later, on the 12th of November, Stephanie gave birth to a infant weighing a small weight – early, tiny yet healthy.

When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been provided shortly before she gave birth.

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

Stephanie had sought recovery repeatedly before birth, and felt awful each time she relapsed. She felt without value, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her dealer would not provide to her when she became clearly expecting.

“However, I failed,” she said. “I needed help.”

The common assumption that her bond with her newborn would make her recover only led to increased guilt and negative self-talk, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.

The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was connected to tubes and leads, so small she thought she would break her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.

Two days later she decided to call her daughter after her caregiver, after the professional who provided support to her.

Medical personnel told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are treated together, not apart.

In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, results get better, foster placements fall and overall savings increase.

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 bring her to the facility.

She stepped out of the hospital still in withdrawal, scared and uncertain about what would happen next.

At the care center, Stephanie still feared that child services would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any point, someone could arrive and take her baby away.

For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”

Life on the streets, she said, was about enduring. Substances came first; faith came last.

Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to let her down. She did not know how to love herself, not to mention anyone else.

Daily, staff from Maddie’s Place drove her to a treatment center, provided orally. Slowly, she was embracing sobriety.

She utilized each moment 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 pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an professional – all frequent conditions 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 be a mom.

One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.

The young ones stared in admiration 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 clad in dark trousers and a sweatshirt, a cap with a bobble on her head, resting on the floor with the door behind her. She is lean. Her posture is humble so you cannot see her face. She is lifting the baby on her lap for the young ones to see and they are crowding near, showing interest to the baby.

Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the men were occupied, handling responsibilities, that they would be there if possible.

“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”

Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could parent.”

Approaches for managing drug-exposed newborns have been used for a long time.

The evaluation method was developed in 1975|