Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, 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 doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she needed to go home to use once more. She thought she still had several weeks to find a way to become sober and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
After five days, on the 12th of November, Stephanie gave birth to a infant weighing 4lb 8oz – premature, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been administered 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 terrible each time she was unsuccessful. She felt hopeless, blaming herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to increased guilt and negative self-talk, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to tubes and leads, so little she thought she would hurt her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms regularly, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: when mothers and babies stay together, results get better, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in recovery, scared and uncertain about what would happen next.
At the facility, Stephanie still was concerned that CPS would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and separate them.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Substances came first; faith came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She did not know how to value herself, not to mention anyone else.
Each day, staff from the center took her to a treatment center, provided orally. Gradually, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an specialist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the young ones to see and they are standing close, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I would become a mother.”
Approaches for managing babies with exposure have been used for a long time.
The assessment tool was created in 1975|
