Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the ER after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she had to return to get high again. She thought she still had several weeks to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
Izzie persuaded 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 transitioned to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
A short time later, on 12 November 2022, Stephanie delivered a daughter weighing 4lb 8oz – early, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she failed. She felt worthless, berating herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The baby was taken to the special care nursery. When Stephanie at last met her, she was connected to medical equipment, so small she thought she would harm her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a new kind of care center where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms regularly, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is showing an important truth: when families are kept intact, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She departed the institution still in detox, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still worried that authorities would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any point, someone could arrive and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She was unable to care for herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a treatment center, administered in pill form. Slowly, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a peer support specialist, visited with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a gray knit hat with a decoration on her head, resting on the floor with the door behind her. She is lean. Her face is downcast so you do not see her expression. She is lifting the baby on her knee for the children to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I would become a mother.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was established in 1975|
