Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she needed to go home to relapse. She thought she still had four weeks left to plan her recovery 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 infection in her legs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie delivered a infant weighing just over four pounds – premature, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her epidural had failed, her final administration of fentanyl had been given four hours before delivery.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her stop using only led to greater shame and self-abuse, a cause for her to use again. 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 special care nursery. When Stephanie finally saw her her, she was connected to tubes and leads, so tiny she thought she would harm her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the professional who provided support to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home where women and their babies 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 treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to pick her up.
She left the medical center still in recovery, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could enter and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Substances 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 lacked the ability to care for herself, much less anyone else.
Each day, staff from the facility transported her to a treatment center, administered in pill form. Gradually, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an specialist – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a peer support specialist, visited with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a beanie with a pompom on her head, seated on the ground with the door behind her. She is thin. Her head is tilted forward so you miss her features. She is lifting the baby on her knee for the other kids to see and they are gathered around, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could be a mom.”
Methods to address drug-exposed newborns have been available for years.
The Finnegan NAS scale was established in 1975|
