Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she resided in a small structure she had constructed in a friend’s yard. She was also addicted to fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a daughter weighing a small weight – premature, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been administered four hours before delivery.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt without value, blaming herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to increased guilt and self-abuse, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the NICU. When Stephanie at last met her, she was attached to monitors, so small she thought she would break her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like the care home is proving a simple point: when families are kept intact, results get better, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in recovery, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still worried that child services would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to cause pain. She was unable to value herself, not to mention anyone else.
Each day, staff from the facility took her to a treatment center, given as medication. 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 sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an professional – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. An advocate, a recovery coach, stopped by with her own children in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the tiny infant 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 holds a picture of the moment. She is clad in casual attire, a cap with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her face is downcast so you miss her features. 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 parents: “Where are all the dads?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I would become a mother.”
Approaches for managing infants affected by substances have been available for years.
The Finnegan NAS scale was developed in 1975|
