Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell visited the medical facility after an infection began spreading up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had consumed opioids 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 a month remaining to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but medical staff detected 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 face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
After five days, on a day in November 2022, Stephanie delivered a baby girl weighing just over four pounds – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her epidural had failed, her previous intake of fentanyl had been given four hours before delivery.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she failed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was attached to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a care center, a unique recovery environment where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to collect her.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could walk in and remove her child.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to cause pain. She lacked the ability to care for herself, let alone anyone else.
Daily, staff from the facility took her to a clinic for methadone, provided orally. Gradually, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a recovery coach, 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 young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a beanie with a decoration on her head, seated on the ground with the door behind her. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her knee for the young ones to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the moms: “Why are there no men?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”
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 established in 1975|
