Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the medical facility after an infection began spreading up her legs. Without a job or home, estranged from her family, she stayed in a makeshift shelter 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 slumped forward and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had a month remaining to find a way to become sober and have this baby.
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 infection in her legs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie delivered a infant weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her last dose of fentanyl had been given four hours before delivery.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her source would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to deeper self-loathing and self-abuse, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was hooked up to tubes and leads, so little she thought she would break her. Holding her for the first time, she felt empty. “I just stared 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 after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, 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 proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to bring her to the facility.
She left the medical center still in withdrawal, fearful and unsure about what would follow.
At the care center, Stephanie still feared that child services would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could walk in and remove her child.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to cause pain. She did not know how to care for herself, let alone anyone else.
Every day, staff from Maddie’s Place transported her to a treatment center, given as medication. Over time, she was embracing sobriety.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an professional – 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 could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. An advocate, a peer support specialist, visited with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her leg for the children to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion 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.”
Tools for treating drug-exposed newborns have been available for years.
The assessment tool was established in 1975|
