Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the ER after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. 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 get high.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had several weeks to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
After five days, on a day in November 2022, Stephanie had a baby girl weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been provided a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she failed. She felt without value, criticizing herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her source refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her quit only led to increased guilt and self-abuse, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was attached to monitors, so small she thought she would break her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where women and their babies are treated together, not apart.
In many parts of America, where a baby is found to have newborn addiction symptoms frequently, 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 the care home is showing an important truth: when mothers and babies stay together, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in recovery, fearful and unsure about what would happen next.
At the care center, Stephanie still worried that authorities would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Substances came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to hurt her. She lacked the ability to love herself, let alone anyone else.
Each day, staff from the center took her to a recovery program, provided orally. Gradually, she was beginning recovery.
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 sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an professional – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor 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. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a bobble on her head, sitting on the wooden floor with the door behind her. She is lean. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her leg for the other kids to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The parents responded that the men were occupied, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
