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Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the medical facility after her infection worsened up her legs. Without a job or home, estranged from her family, she lived in a shed she had built in a friend’s yard. 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 vomited.

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

She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had several weeks to find a way to become sober and deliver her child.

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

“I am leaving,” Stephanie said.

But the hospital refused to discharge her: the leg infection was serious, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.

She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.

A short time later, on the 12th of November, Stephanie delivered a infant weighing just over four pounds – early, tiny yet healthy.

When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered a few hours prior to birth.

She felt ill. Not ready for motherhood. Unworthy.

Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she was unsuccessful. She felt worthless, berating herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her supplier would not provide to her when she became clearly expecting.

“Yet I was unable,” she said. “I needed help.”

The common assumption that her affection for her child would make her recover only led to deeper self-loathing and negative self-talk, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a chronic disease.

The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was attached to monitors, so tiny she thought she would break her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.

Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.

Medical personnel told her about a specialized facility, a innovative treatment home where women and their babies are cared for jointly, not apart.

In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a small, growing network of centers like the care home is showing an important truth: when families are kept intact, results get better, custody cases decrease and overall savings increase.

It took Stephanie a while to gather the courage 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, scared and uncertain about what would follow.

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At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and separate them.

For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”

Life on the streets, she said, was about survival. Addiction came first; faith came last.

Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She did not know how to value herself, not to mention anyone else.

Daily, staff from Maddie’s Place transported her to a treatment center, provided orally. Over time, she was starting to get clean.

She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an professional – all typical problems for babies born with NAS.

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 remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.

The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”

She keeps a photo of the moment. She is clad in casual attire, a beanie with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her lap for the children to see and they are standing close, showing interest to the baby.

Jacob, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there if they could.

“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”

Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I would become a mother.”

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Tools for treating drug-exposed newborns have been used for a long time.

The assessment tool was developed in 1975|