Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the ER after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had assembled in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had four weeks left to find a way to become sober and have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
A short time later, on the 12th of November, Stephanie gave birth to a daughter weighing a small weight – premature, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her pain relief did not work, her last dose of fentanyl had been given a few hours prior to birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she relapsed. She felt without value, criticizing herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her stop using only led to deeper self-loathing and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to monitors, so tiny she thought she would hurt her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to collect her.
She departed the institution still in recovery, anxious and doubtful about what would follow.
At the care center, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and take her baby away.
For the first two weeks, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to care for herself, much less anyone else.
Daily, staff from the facility drove her to a treatment center, given as medication. Slowly, she was beginning recovery.
She spent every minute 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 adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an professional – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a peer support specialist, stopped by with her own five kids in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the entryway at her back. She is lean. Her posture is humble so you do not see her expression. She is presenting her daughter on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was established in 1975|
