Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.

Eight months pregnant and in severe pain, Stephanie Rosell went to the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.

As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and became sick.

Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”

She had consumed opioids before arriving at the hospital and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had several weeks to plan her recovery and have this baby.

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

“I am leaving,” Stephanie said.

But the doctors would not let her go: the infection in her legs was serious, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.

The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.

After five days, on a day in November 2022, Stephanie delivered a daughter weighing just over four pounds – born before term, little but surviving.

When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her previous intake of fentanyl had been provided a few hours prior to birth.

She felt ill. Unprepared to be a mother. Undeserving.

Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she failed. She felt without value, berating herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.

“However, I failed,” she said. “I needed help.”

The common assumption that her bond with her newborn would make her quit only led to increased guilt and self-harm, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.

The newborn was transferred to the special care nursery. When Stephanie at last met her, she was attached to tubes and leads, so tiny she thought she would hurt her. Embracing her at last, 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.

After two days she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.

Medical personnel told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.

In many parts of America, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, foster placements fall and overall savings increase.

It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to bring her to the facility.

She stepped out of the hospital still in withdrawal, scared and uncertain about what would happen next.

At the facility, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The fear lingered: 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 didn’t have a lot of trust at that point.”

Homelessness, she said, was about enduring. Substances came first; reliance came last.

Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She was unable to care for herself, not to mention anyone else.

Daily, staff from the facility transported her to a treatment center, given as medication. Gradually, she was embracing sobriety.

She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an specialist – all typical problems for babies exposed to substances.

If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.

On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, visited with her own children in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.

The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”

She keeps a photo of the moment. She is dressed in casual attire, a gray knit hat with a bobble on her head, resting on the floor with the entryway at her back. She is lean. Her posture is humble so you cannot see her face. She is lifting the baby on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.

One child, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there given the chance.

“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”

Stephanie and Bunch-Smith exchanged glances. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”

Tools for treating infants affected by substances have been used for a long time.

The evaluation method was established in 1975|