Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the medical facility after an infection began spreading up her legs. Without a job or home, separated from loved ones, she lived in a shed she had built in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she had to return to relapse. She thought she still had several weeks to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a infant weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her pain relief did not work, her last dose of fentanyl had been provided four hours before delivery.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she failed. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her source declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her recover only led to deeper self-loathing and negative self-talk, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to medical equipment, so tiny she thought she would harm her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like this facility is demonstrating a key fact: when families are kept intact, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to collect her.
She left the medical center still in detox, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still was concerned that child services would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to cause pain. She did not know how to love herself, not to mention anyone else.
Daily, staff from Maddie’s Place took her to a recovery program, provided orally. Slowly, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for guided meetings with their babies. An advocate, a mentor, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She has an image of the moment. She is clad in black pants and a hoodie, a beanie with a decoration on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you cannot see her face. She is lifting the baby on her knee for the children to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I would become a mother.”
Methods to address drug-exposed newborns have existed for decades.
The Finnegan NAS scale was established in 1975|
