Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had several weeks to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
After five days, on 12 November 2022, Stephanie had a infant weighing 4lb 8oz – early, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been given shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she relapsed. She felt worthless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her recover only led to deeper self-loathing and self-harm, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was hooked up to medical equipment, so small she thought she would hurt her. Holding her for the first time, she felt empty. “I looked 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 the same as her nurse, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms regularly, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a developing system of centers like this facility is showing an important truth: when mothers and babies stay together, results get better, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to pick her up.
She left the medical center still in detox, fearful and unsure about what would follow.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could arrive and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She did not know how to love herself, let alone anyone else.
Daily, staff from the facility drove her to a clinic for methadone, provided orally. Gradually, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, visited with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is clad in casual attire, a gray knit hat with a bobble on her head, resting on the floor with the door behind her. She is lean. Her face is downcast so you miss her features. She is lifting the baby on her lap for the children to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I would become a mother.”
Methods to address drug-exposed newborns have existed for decades.
The evaluation method was developed in 1975|
