Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the hospital emergency room after her infection worsened up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had four weeks left to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
A short time later, on a day in November 2022, Stephanie gave birth to a baby girl weighing just over four pounds – premature, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she relapsed. She felt without value, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her dealer declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her love for her baby would make her stop using only led to deeper self-loathing and self-harm, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was attached to monitors, so little she thought she would break her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition frequently, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like the care home is showing an important truth: when parents and infants remain united, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in recovery, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could walk in and take her baby away.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Substances came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to hurt her. She lacked the ability to value herself, let alone anyone else.
Each day, staff from the center took her to a recovery program, provided orally. Gradually, she was starting to get clean.
She devoted all her time beyond therapy 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 pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an specialist – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, 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 supervised visits with their babies. An advocate, a peer support specialist, stopped by with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is wearing black pants and a hoodie, a gray knit hat 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 do not see her expression. She is presenting her daughter on her lap for the young ones to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion looked at each other. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could parent.”
Tools for treating infants affected by substances have been used for a long time.
The Finnegan NAS scale was created in 1975|
