Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had built in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she had to return to use once more. She thought she still had a month remaining to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth 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 a small weight – premature, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been given four hours before delivery.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she relapsed. She felt worthless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her quit only led to greater shame and negative self-talk, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to medical equipment, so small she thought she would harm her. Holding her for the first time, she felt detached. “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.
Following a brief period she decided to call her daughter Izzie, after the professional who provided support to her.
Medical personnel told her about a care center, 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 diagnosed with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, results get better, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, care providers came to bring her to the facility.
She departed the institution still in withdrawal, scared and uncertain about what would follow.
At the care center, Stephanie still feared that child services would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could arrive and remove her child.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Drugs came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Each day, staff from the center took her to a recovery program, given as medication. Slowly, she was embracing sobriety.
She utilized each moment 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 intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own children in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is dressed in casual attire, a cap with a bobble on her head, sitting on the wooden floor with the door behind her. She is lean. Her face is downcast so you cannot see her face. She is lifting the baby on her leg for the young ones to see and they are standing close, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I would become a mother.”
Approaches for managing drug-exposed newborns have been available for years.
The assessment tool was created in 1975|
