Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell went to the ER after her infection worsened up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had four weeks left to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie gave birth to a infant weighing just over four pounds – premature, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been given four hours before delivery.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she relapsed. She felt hopeless, berating herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer 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 quit only led to deeper self-loathing and negative self-talk, a trigger 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 baby was taken to the NICU. When Stephanie at last met her, she was hooked up to monitors, so little she thought she would hurt her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to collect her.
She left the medical center still in detox, anxious and doubtful about what would happen next.
At the facility, Stephanie still feared that child services would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could arrive and remove her child.
For the beginning period, Stephanie remained isolated. “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. Addiction came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to love herself, not to mention anyone else.
Each day, staff from the facility drove her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an professional – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. An advocate, a recovery coach, 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 showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a decoration on her head, seated on the ground with the entryway at her back. She is slender. Her head is tilted forward so you miss her features. 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 parents: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address babies with exposure have been used for a long time.
The evaluation method was developed in 1975|