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Eight months pregnant and in severe pain, Stephanie Rosell went to the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had built in a companion's property. She was also addicted to fentanyl.

As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and threw up.

Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”

She had used fentanyl before seeking medical help and had only a brief window to get treated before she needed to go home to get high again. She thought she still had four weeks left to find a way to become sober and deliver her child.

The attending nurse disagreed. She told Stephanie she was staying put.

“I will go,” Stephanie said.

But the hospital refused to discharge her: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, 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 at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.

After five days, on the 12th of November, Stephanie gave birth to a daughter weighing just over four pounds – born before term, little but surviving.

When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been given four hours before delivery.

She felt unwell. Not ready for motherhood. Not fit.

Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she failed. She felt hopeless, berating herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her source would not provide to her when she became obviously with child.

“But I couldn’t,” she said. “I had to seek support.”

The widespread belief that her bond with her newborn would make her stop using only led to greater shame and self-abuse, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.

The infant was moved to the special care nursery. When Stephanie eventually visited her, she was connected to medical equipment, so little she thought she would hurt her. Holding her for the first time, she felt nothing. “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.

After two days she decided to name her baby Izzie, after the professional who provided support to her.

Hospital staff told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.

In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, recovery succeeds, custody cases decrease and future expenses reduce.

It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to pick her up.

She departed the institution still in withdrawal, scared and uncertain about what would happen next.

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At the facility, Stephanie still feared that CPS would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could walk in and take her baby away.

For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”

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

Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She lacked the ability to love herself, much less anyone else.

Each day, staff from the center transported her to a clinic for methadone, administered in pill form. Over time, she was beginning recovery.

She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all common issues for babies born with NAS.

When a child recognizes these infants need affection, then I found the strength. I would become a mother.

During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. A support specialist, a peer support specialist, visited with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.

The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”

She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, seated on the ground with the door behind her. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her lap for the other kids to see and they are standing close, fawning and reaching out to the baby.

One child, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there given the chance.

“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”

Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I could parent.”

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Methods to address babies with exposure have existed for decades.

The evaluation method was developed in 1975|