🔗 Share this article

In her eighth month of pregnancy and suffering, the expectant mother went to the ER after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had constructed in a companion's property. She was also addicted to fentanyl.

As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and became sick.

Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”

She had used fentanyl before seeking medical help and had just enough time to get treated before she had to return to relapse. She thought she still had four weeks left to find a way to become sober and have this baby.

The medical professional intervened. She told Stephanie she was staying put.

“I will go,” Stephanie said.

But the doctors would not let her go: the condition in her limbs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.

She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.

A short time later, on the 12th of November, Stephanie had a infant weighing just over four pounds – born before term, little but surviving.

When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.

She felt sick. Not ready for motherhood. Unworthy.

Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she relapsed. She felt hopeless, criticizing herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her source refused to sell to her when she became visibly pregnant.

“But I couldn’t,” she said. “I required assistance.”

The pervasive expectation that her bond with her newborn would make her quit only led to deeper self-loathing and self-harm, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.

The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so small she thought she would hurt her. Embracing her at last, she felt nothing. “I looked at 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 call her daughter the same as her nurse, after the nurse who had been so kind to her.

Medical personnel told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.

In numerous states, where a baby is identified with newborn addiction symptoms regularly, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, custody cases decrease and future expenses reduce.

It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.

She left the medical center still in withdrawal, anxious and doubtful about what would follow.

---

At Maddie’s Place, Stephanie still worried that CPS would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could walk in and separate them.

For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”

Homelessness, she said, was about enduring. Drugs 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 care for herself, much less anyone else.

Each day, staff from the center took her to a treatment center, given as medication. Slowly, she was starting to get clean.

She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an professional – all common issues 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.

One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a mentor, stopped by with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.

The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”

She has an image of the moment. She is dressed in casual attire, a gray knit hat with a decoration on her head, seated on the ground with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her lap for the children to see and they are gathered around, showing interest to the baby.

One child, eight, asked the moms: “Why are there no men?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.

“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”

Stephanie and her companion made eye contact. “I broke down,” 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 infants affected by substances have existed for decades.

The Finnegan NAS scale was created in 1975|