Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had several weeks to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but physicians found 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.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
A short time later, on 12 November 2022, Stephanie gave birth to a baby girl weighing a small weight – premature, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she was unsuccessful. She felt worthless, blaming herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her dealer would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her stop using only led to deeper self-loathing and self-abuse, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, 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 remained uncertain she wanted to be her mother.
Two days later she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a unique recovery environment where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is found to have infant withdrawal condition regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is showing an important truth: when families are kept intact, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. 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 withdrawal, anxious and doubtful about what would follow.
At the facility, Stephanie still was concerned that child services would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and take her baby away.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Addiction came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, administered in pill form. Over time, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an professional – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own children in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, seated on the ground with the entryway at her back. She is thin. Her head is tilted forward so you miss her features. She is presenting her daughter on her knee for the other kids to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could parent.”
Methods to address babies with exposure have existed for decades.
The evaluation method was created in 1975|