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Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had constructed in a acquaintance's garden. She was also addicted to fentanyl.

As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and threw up.

Stephanie finally broke down. “I have to get out of here. 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 was compelled to leave to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.

The medical professional intervened. She told Stephanie she was not allowed to leave.

“I will go,” Stephanie said.

But the doctors would not let her go: the infection in her legs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.

She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.

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

When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was detached. Her epidural had failed, her final administration of fentanyl had been provided shortly before she gave birth.

She felt sick. Ill-equipped for parenting. Undeserving.

Stephanie had sought recovery multiple times while expecting, and felt horrible each time she failed. She felt without value, berating herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her source would not provide to her when she became visibly pregnant.

“But I couldn’t,” she said. “I needed help.”

The widespread belief that her affection for her child would make her stop using only led to increased guilt and self-abuse, 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 persistent condition.

The baby was taken to the special care nursery. When Stephanie at last met her, she was attached to tubes and leads, so small she thought she would break her. Cradling her initially, she felt empty. “I just stared 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 professional who provided support to her.

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

In numerous states, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a developing system 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 some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.

She left the medical center still in recovery, anxious and doubtful about what would happen next.

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

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

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

Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to hurt her. She lacked the ability to care for herself, much less anyone else.

Daily, staff from the facility drove her to a recovery program, given as medication. Over time, she was embracing sobriety.

She devoted all her time when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an professional – all frequent conditions for babies affected by withdrawal.

If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.

One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. A support specialist, a mentor, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.

The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”

She holds a picture of the moment. She is dressed in black pants and a hoodie, a beanie with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her leg for the other kids to see and they are gathered around, showing interest to the baby.

Jacob, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there if they could.

“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”

Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could be a mom.”

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Approaches for managing babies with exposure have been available for years.

The Finnegan NAS scale was developed in 1975|