Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the ER after her infection worsened up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had built in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie delivered a baby girl weighing a small weight – premature, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she relapsed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her source declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her stop using only led to deeper self-loathing and self-harm, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was connected to medical equipment, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when parents and infants remain united, results get better, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, anxious and doubtful about what would follow.
At Maddie’s Place, Stephanie still feared that child services would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Substances came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to let her down. She did not know how to value herself, let alone anyone else.
Daily, staff from the facility took her to a clinic for methadone, administered in pill form. Gradually, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an professional – 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 remained in the shared space, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own children in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a beanie with a bobble on her head, sitting on the wooden floor with the exit nearby. She is slender. Her posture is humble so you cannot see her face. She is lifting the baby on her lap for the other kids to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was developed in 1975|