Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the medical facility after an infection began spreading up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had assembled in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she had to return to use once more. She thought she still had four weeks left to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – born before term, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to deeper self-loathing and negative self-talk, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie at last met her, she was attached to tubes and leads, so tiny she thought she would harm her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a new kind of care center where women and their babies are treated together, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a developing system of centers like the care home is showing an important truth: when mothers and babies stay together, 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 ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in recovery, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still feared that child services would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could walk in and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Substances came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to cause pain. She was unable to value herself, let alone anyone else.
Each day, staff from the facility transported her to a clinic for methadone, provided orally. Gradually, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a mentor, came over with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, sitting on the wooden floor with the exit nearby. She is slender. Her head is tilted forward so you do not see her expression. She is lifting the baby on her leg for the other kids to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the parents: “Why are there no men?” The parents responded that the dads were busy, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I would become a mother.”
Tools for treating babies with exposure have been available for years.
The Finnegan NAS scale was developed in 1975|
