Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.

In her eighth month of pregnancy and suffering, Stephanie Rosell visited the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had constructed in a acquaintance's garden. She was also dependent on fentanyl.

As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and vomited.

Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”

She had used fentanyl before coming to the ER and had only a brief window to get treated before she needed to go home to use once more. She thought she still had four weeks left to plan her recovery and give birth.

The medical professional intervened. She told Stephanie she was not going anywhere.

“I will go,” Stephanie said.

But the hospital refused to discharge her: the infection in her legs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.

Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.

A short time later, on 12 November 2022, Stephanie had a infant weighing just over four pounds – premature, little but surviving.

When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been provided shortly before she gave birth.

She felt unwell. Unprepared to be a mother. Not fit.

Stephanie had tried to get clean multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her dealer would not provide to her when she became visibly pregnant.

“Yet I was unable,” she said. “I had to seek support.”

The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.

The baby was taken to the NICU. When Stephanie at last met her, she was hooked up to tubes and leads, so tiny she thought she would break her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.

Two days later she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.

Hospital staff told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns 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 child-protection investigations. But a developing system of centers like this facility is demonstrating a key fact: when parents and infants remain united, outcomes improve, foster placements fall and overall savings increase.

It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to collect her.

She departed the institution still in detox, anxious and doubtful about what would happen next.

At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could arrive and take her baby away.

For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”

Life on the streets, she said, was about getting by. Drugs came first; reliance came last.

Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to let her down. She was unable to value herself, let alone anyone else.

Every day, staff from the center transported her to a recovery program, administered in pill form. Slowly, she was beginning recovery.

She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all common issues for babies exposed to substances.

Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.

On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a mentor, came over with her own five kids in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.

The young ones stared in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”

She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a decoration 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 holding Izzie up on her lap for the other kids to see and they are gathered around, admiring and touching to the baby.

A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the fathers had obligations, handling responsibilities, 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 became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could parent.”

Approaches for managing infants affected by substances have been used for a long time.

The evaluation method was established in 1975|