Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the ER after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before seeking medical help and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
Five days later, on the 12th of November, Stephanie had a baby girl weighing just over four pounds – early, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she failed. She felt worthless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her supplier would not provide 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 quit only led to deeper self-loathing and self-harm, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to medical equipment, so tiny she thought she would harm her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period 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 a care center, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) 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 Maddie’s Place is showing an important truth: when parents and infants remain united, outcomes improve, 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, a couple of employees came to collect her.
She left the medical center still in withdrawal, fearful and unsure about what would follow.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could enter and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Substances came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She was unable to love herself, let alone anyone else.
Each day, staff from the center transported her to a clinic for methadone, given as medication. Slowly, she was beginning recovery.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an professional – all frequent conditions 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 be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. An advocate, a peer support specialist, visited with her own five kids in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration of the small baby 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 holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a cap with a bobble on her head, resting on the floor with the exit nearby. She is lean. Her face is downcast so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are gathered around, fawning and reaching out 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, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I was able. I would become a mother.”
Methods to address babies with exposure have been used for a long time.
The evaluation method was created in 1975|
