Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell visited the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had assembled in a friend’s yard. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
A short time later, on the 12th of November, Stephanie had a infant weighing a small weight – premature, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she failed. She felt worthless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her source would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her love for her baby would make her recover only led to increased guilt and self-abuse, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The infant was moved to the NICU. When Stephanie at last met her, she was attached to monitors, so tiny she thought she would harm her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter after her caregiver, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a unique recovery environment where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms regularly, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, care providers came to pick her up.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could enter and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “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 trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from Maddie’s Place transported her to a clinic for methadone, given as medication. Slowly, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. A support specialist, a mentor, stopped by with her own children in tow to deliver baked goods. They all gathered around 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. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a pompom on her head, sitting on the wooden floor with the door behind her. She is thin. Her head is tilted forward so you do not see her expression. She is lifting the baby on her lap for the children to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion looked at each other. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”
Methods to address drug-exposed newborns have been available for years.
The assessment tool was created in 1975|
