Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had built in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had a month remaining to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, 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 be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned 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 gave birth to a daughter weighing just over four pounds – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt worthless, blaming herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her supplier would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her quit only led to deeper self-loathing and self-harm, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the NICU. When Stephanie finally saw her her, she was attached to medical equipment, so tiny she thought she would harm her. Embracing her at last, 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.
Following a brief period 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 mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is identified with infant withdrawal condition regularly, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and long-term costs decline.
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, a couple of employees came to pick her up.
She left the medical center still in withdrawal, fearful and unsure about what would come next.
At the care center, Stephanie still feared that authorities would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could arrive and separate them.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to value herself, much less anyone else.
Every day, staff from Maddie’s Place drove her to a treatment center, administered in pill form. Over time, she was beginning recovery.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had sensory challenges 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 found the strength. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a peer support specialist, stopped by with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder 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 has an image of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her face is downcast so you miss her features. She is holding Izzie up on her leg for the children 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 women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could parent.”
Tools for treating infants affected by substances have been available for years.
The assessment tool was developed in 1975|