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In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after her infection worsened up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a companion's property. She was also hooked on fentanyl.

As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. 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 take a hit.”

She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she needed to go home to get high again. She thought she still had several weeks to plan her recovery and have this baby.

The nurse had other ideas. She told Stephanie she was not going anywhere.

“I will go,” Stephanie said.

But the doctors would not let her go: the infection in her legs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would not survive.

Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to 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 daughter weighing 4lb 8oz – premature, little but surviving.

When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been administered a few hours prior to birth.

She felt ill. Unprepared to be a mother. Not fit.

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

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

The common assumption that her affection for her child would make her quit only led to greater shame and self-abuse, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.

The newborn was transferred to the NICU. When Stephanie eventually visited her, she was hooked up to tubes and leads, so little she thought she would hurt her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.

After two days she decided to call her daughter Izzie, after the attendant who showed compassion to her.

Medical personnel told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.

In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) 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 this facility is demonstrating a key fact: when parents and infants remain united, recovery succeeds, foster placements fall and long-term costs decline.

It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to bring her to the facility.

She left the medical center still in detox, fearful and unsure about what would follow.

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At the care center, Stephanie still worried that CPS would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could enter and take her baby away.

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

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

Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to let her down. She did not know how to care for herself, let alone anyone else.

Daily, staff from the facility took her to a recovery program, given as medication. Over time, she was beginning recovery.

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 pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an specialist – all common issues for babies born with NAS.

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

On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. An advocate, a peer support specialist, visited with her own family in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.

The young ones stared in awe of the tiny infant in Stephanie’s arms. “They were innocent,” 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, resting on the floor with the door behind her. She is thin. Her face is downcast so you cannot see her face. She is holding Izzie up on her leg for the children to see and they are gathered around, admiring and touching to the baby.

A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the dads were busy, engaged elsewhere, that they would be there given the chance.

“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”

Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”

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Tools for treating drug-exposed newborns have existed for decades.

The Finnegan NAS scale was developed in 1975|