Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she resided in a small structure she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had taken the drug before seeking medical help and had just enough time to get treated before she had to return to get high again. She thought she still had a month remaining to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
Five days later, on the 12th of November, Stephanie had a baby girl weighing just over four pounds – born before term, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she failed. She felt worthless, criticizing herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The common assumption that her affection for her child would make her stop using only led to deeper self-loathing and self-abuse, a trigger 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 infant was moved to the NICU. When Stephanie eventually visited her, she was connected to monitors, so small she thought she would hurt her. Cradling her initially, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, two staff members came to pick her up.
She stepped out of the hospital still in recovery, fearful and unsure about what would follow.
At the care center, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She did not know how to care for herself, not to mention anyone else.
Each day, staff from Maddie’s Place drove her to a recovery program, administered in pill form. Over time, she was embracing sobriety.
She spent every minute when not in sessions 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 nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own children in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a beanie with a pompom on her head, resting on the floor with the entryway at her back. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her knee for the young ones to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the parents: “What about the fathers?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The assessment tool was created in 1975|
