Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had built in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she had to return to relapse. She thought she still had several weeks to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – premature, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she failed. She felt worthless, criticizing herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her stop using only led to increased guilt and negative self-talk, a cause for her to use again. 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 tubes and leads, so small she thought she would harm her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a innovative treatment home where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, recovery succeeds, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to pick her up.
She left the medical center still in recovery, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could enter and take her baby away.
For the beginning period, Stephanie kept to herself. “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 getting by. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She was unable to love herself, not to mention anyone else.
Daily, staff from the center transported her to a treatment center, provided orally. Gradually, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, stopped by with her own children in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image 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 slender. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her lap for the young ones to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could parent.”
Methods to address babies with exposure have been available for years.
The assessment tool was established in 1975|
