Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had constructed in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had just enough time to get treated before she needed to go home to use once more. She thought she still had several weeks to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
After five days, on 12 November 2022, Stephanie had a daughter weighing 4lb 8oz – premature, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she was unsuccessful. She felt hopeless, berating herself for not being able to achieve the unattainable. An obstetrician told her to “simply” 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 love for her baby would make her recover only led to increased guilt and self-harm, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could will away a long-term illness.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to monitors, so little she thought she would harm her. Embracing her at last, she felt nothing. “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 give her child the name after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a new kind of care center 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 whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like this facility is demonstrating a key fact: when parents and infants remain united, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would happen next.
At the facility, Stephanie still worried that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could enter and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to cause pain. She lacked the ability to value herself, not to mention anyone else.
Every day, staff from Maddie’s Place took her to a recovery program, provided orally. Over time, she was beginning recovery.
She utilized each moment 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 obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, came over with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She keeps a photo of the moment. She is wearing casual attire, a cap with a bobble on her head, resting on the floor with the entryway at her back. She is slender. Her posture is humble so you do not see her expression. She is lifting the baby on her leg for the children to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there if possible.
“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 just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”
Tools for treating infants affected by substances have been available for years.
The assessment tool was created in 1975|
