Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the ER after an infection began spreading up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had constructed in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had just enough time to get treated before she had to return to relapse. She thought she still had four weeks left to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
A short time later, on the 12th of November, Stephanie delivered a daughter weighing just over four pounds – early, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she relapsed. She felt hopeless, criticizing herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her supplier would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her stop using only led to increased guilt and self-abuse, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was hooked up to medical equipment, so tiny she thought she would break her. Embracing her at last, she felt nothing. “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.
Following a brief period she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, 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 Maddie’s Place is proving a simple point: when mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, care providers came to collect her.
She stepped out of the hospital still in detox, anxious and doubtful about what would happen next.
At the care center, Stephanie still worried that authorities would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any point, someone could arrive and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about survival. Drugs 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 hurt her. She lacked the ability to value herself, let alone anyone else.
Every day, staff from the center took her to a recovery program, provided orally. Over time, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. An advocate, a peer support specialist, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a decoration on her head, seated on the ground with the door behind her. She is thin. Her face is downcast so you do not see her expression. She is presenting her daughter on her leg for the young ones to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the moms: “Why are there no men?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I would become a mother.”
Tools for treating babies with exposure have been used for a long time.
The evaluation method was created in 1975|
