Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell visited the medical facility after her infection worsened up her legs. Without a job or home, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had several weeks to find a way to become sober and have this baby.
The medical professional intervened. 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 severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
A short time later, on 12 November 2022, Stephanie delivered a infant weighing 4lb 8oz – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she failed. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her supplier refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her affection for her child would make her quit only led to deeper self-loathing and self-abuse, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to monitors, so little she thought she would hurt her. Holding her for the first time, 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.
Two days later she decided to name her baby after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where women and their babies are treated together, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when parents and infants remain united, recovery succeeds, 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 verifying her eligibility 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 the care center, Stephanie still was concerned that child services would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could enter and separate them.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to cause pain. She was unable to care for herself, let alone anyone else.
Every day, staff from the facility transported her to a treatment center, administered in pill form. Gradually, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. An advocate, a mentor, stopped by with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She has an image of the moment. She is dressed in casual attire, a gray knit hat with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the parents: “Where are all the dads?” The parents responded that the men were occupied, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I could be a mom.”
Methods to address infants affected by substances have existed for decades.
The evaluation method was established in 1975|