Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had used fentanyl before coming to the ER and had sufficient opportunity 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 allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
A short time later, on a day in November 2022, Stephanie delivered a daughter weighing 4lb 8oz – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered a few hours prior to birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she failed. She felt without value, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, 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 special care nursery. When Stephanie finally saw her her, she was hooked up to monitors, so small she thought she would hurt her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like the care home is showing an important truth: when mothers and babies stay together, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to bring her to the facility.
She departed the institution still in recovery, fearful and unsure about what would come next.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could walk in and separate them.
For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to let her down. She lacked the ability to care for herself, much less anyone else.
Daily, staff from Maddie’s Place transported her to a treatment center, given as medication. Gradually, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a mentor, came over with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her posture is humble so you do not see her expression. She is lifting the baby on her lap for the children to see and they are gathered around, showing interest to the baby.
One child, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could be a mom.”
Tools for treating babies with exposure have been available for years.
The evaluation method was created in 1975|
