Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
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. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and vomited.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
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 plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
Five days later, on 12 November 2022, Stephanie delivered a daughter weighing a small weight – born before term, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her epidural had failed, her previous intake of fentanyl had been given four hours before delivery.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her recover only led to deeper self-loathing and self-harm, a impetus 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 neonatal intensive care unit. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would harm 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 name her baby the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a unique recovery environment where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms regularly, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a while to gather the courage 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 come next.
At the facility, Stephanie still was concerned that authorities would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to let her down. She was unable to value herself, let alone anyone else.
Every day, staff from the facility took her to a recovery program, administered in pill form. Gradually, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an professional – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, stopped by with her own family in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a beanie with a decoration on her head, sitting on the wooden floor with the door behind her. She is thin. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the young ones to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the dads were busy, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I was able. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
