Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the ER after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had assembled in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to relapse. She thought she still had several weeks to find a way to become sober and deliver her child.
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 infection in her legs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a infant weighing just over four pounds – early, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her epidural had failed, her previous intake of fentanyl had been given four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her source refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The widespread belief that her affection for her child would make her quit only led to greater shame and self-harm, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to tubes and leads, so little she thought she would break her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where women and their babies are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like this facility is demonstrating a key fact: when families are kept intact, results get better, custody cases decrease and long-term costs decline.
It took Stephanie a period to find strength to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in withdrawal, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could enter and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She lacked the ability to care for herself, let alone anyone else.
Daily, staff from the center transported her to a clinic for methadone, given as medication. Gradually, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own five kids in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the young ones to see and they are standing close, showing interest to the baby.
One child, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the fathers had obligations, engaged elsewhere, 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 her companion exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could be a mom.”
Methods to address infants affected by substances have existed for decades.
The evaluation method was created in 1975|
