Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the medical facility after her infection worsened up her legs. Without a job or home, estranged from her family, she lived in a shed she had constructed in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had taken the drug before seeking medical help and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a infant weighing 4lb 8oz – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been given four hours before delivery.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she was unsuccessful. She felt worthless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“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 greater shame 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 eliminate a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, fewer children enter care and overall savings increase.
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, care providers came to collect her.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and remove her child.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She did not know how to care for herself, not to mention anyone else.
Daily, staff from the center transported her to a treatment center, administered in pill form. Gradually, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She keeps a photo of the moment. She is wearing black pants and a hoodie, a cap with a decoration on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you miss her features. She is presenting her daughter on her knee for the children to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion made eye contact. “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 drug-exposed newborns have been available for years.
The Finnegan NAS scale was established in 1975|
