Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had just enough time to get treated before she needed to go home to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
A short time later, on a day in November 2022, Stephanie had a daughter weighing just over four pounds – born before term, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she failed. She felt without value, criticizing herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her recover only led to deeper self-loathing and self-harm, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up 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, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is identified with newborn addiction symptoms regularly, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a developing system of centers like this facility is demonstrating a key fact: when parents and infants remain united, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to pick her up.
She departed the institution still in detox, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still worried that authorities would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could walk in and remove her child.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She did not know how to care for herself, not to mention anyone else.
Every day, staff from the facility transported her to a recovery program, given as medication. Over time, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an specialist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. A support specialist, a mentor, stopped by with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a pompom 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 presenting her daughter on her lap for the other kids to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The parents responded that the dads were busy, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I would become a mother.”
Methods to address infants affected by substances have been used for a long time.
The Finnegan NAS scale was created in 1975|