Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
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 lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to get high again. She thought she still had four weeks left to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
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 transitioned to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
After five days, on 12 November 2022, Stephanie delivered a infant weighing a small weight – born before term, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been given a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she failed. She felt without value, blaming herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her quit only led to greater shame and self-harm, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to monitors, so tiny she thought she would break her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where women and their babies are treated together, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs 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 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 departed the institution still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and remove her child.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She lacked the ability to love herself, much less anyone else.
Each day, staff from the facility drove her to a treatment center, provided orally. Gradually, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is wearing casual attire, a gray knit hat with a bobble on her head, seated on the ground with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is presenting her daughter on her knee for the children to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “Why are there no men?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I would become a mother.”
Approaches for managing babies with exposure have been available for years.
The Finnegan NAS scale was established in 1975|
