Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had assembled in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. 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 use drugs.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she had to return to relapse. She thought she still had several weeks to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
After five days, on the 12th of November, Stephanie delivered a daughter weighing just over four pounds – born before term, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she relapsed. She felt without value, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her recover only led to deeper self-loathing and self-harm, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so tiny she thought she would hurt her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like the care home is demonstrating a key fact: when mothers and babies stay together, outcomes improve, custody cases decrease and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in recovery, fearful and unsure about what would happen next.
At the care center, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any time, someone could walk in and remove her child.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to hurt her. She was unable to care for herself, let alone anyone else.
Daily, staff from Maddie’s Place transported her to a recovery program, administered in pill form. Slowly, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in casual attire, a gray knit hat with a pompom on her head, seated on the ground with the exit nearby. She is lean. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the young ones to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could be a mom.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was developed in 1975|
