Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the ER after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she needed to go home to get high again. She thought she still had several weeks to plan her recovery 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 critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
Five days later, on the 12th of November, Stephanie delivered a daughter weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been administered a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she failed. She felt worthless, blaming herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her supplier declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her affection for her child would make her recover only led to greater shame and negative self-talk, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was connected to tubes and leads, so little she thought she would hurt her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when families are kept intact, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to collect her.
She left the medical center still in recovery, fearful and unsure about what would follow.
At the facility, Stephanie still worried that authorities would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could arrive and separate them.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, 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.
Daily, staff from the facility took her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an specialist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. A support specialist, a mentor, visited with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They had no care in the world,” 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 clad in black pants and a hoodie, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is holding Izzie up on her leg for the children to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I would become a mother.”
Tools for treating drug-exposed newborns have been available for years.
The assessment tool was developed in 1975|
