Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the hospital emergency room after an infection began spreading up her legs. Without a job or home, estranged from her family, she stayed in a makeshift shelter she had built in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity 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 give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but doctors had discovered 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.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
After five days, on 12 November 2022, Stephanie had a baby girl weighing just over four pounds – born before term, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she relapsed. She felt without value, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her stop using only led to increased guilt and self-harm, a cause 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 NICU. When Stephanie at last met her, she was hooked up to monitors, so tiny she thought she would harm her. Holding her for the first time, she felt nothing. “I looked at 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 the same as her nurse, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is found to have infant withdrawal condition frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when mothers and babies stay together, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, care providers came to pick her up.
She departed the institution still in detox, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still was concerned 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 point, someone could walk in and separate them.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Each day, staff from the center transported her to a clinic for methadone, given as medication. Over time, she was beginning recovery.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues 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 found the strength. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a mentor, visited with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the tiny infant 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 dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the children to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The parents responded that the fathers had obligations, called away to other tasks, 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 her companion looked at each other. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I would become a mother.”
Methods to address infants affected by substances have existed for decades.
The Finnegan NAS scale was created in 1975|
