Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the hospital emergency room after her infection worsened up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had built in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie eventually collapsed. “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 was compelled to leave to get high again. She thought she still had several weeks to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie gave birth to a baby girl weighing a small weight – premature, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she relapsed. She felt without value, berating herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her source would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her stop using only led to increased guilt and negative self-talk, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was connected to monitors, so small she thought she would harm her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘What is our future?’” 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.
Medical personnel told her about a specialized facility, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals 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 ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She departed the institution still in withdrawal, fearful and unsure about what would come next.
At the facility, Stephanie still worried that authorities would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could enter and separate them.
For the first two weeks, Stephanie stayed withdrawn. “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 enduring. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to cause pain. She lacked the ability to value herself, let alone anyone else.
Every day, staff from the facility transported her to a treatment center, given as medication. Over time, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an specialist – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a mentor, stopped by with her own five kids in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She has an image of the moment. She is dressed in casual attire, a beanie with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her face is downcast so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the men were occupied, called away to other tasks, that they would be there if possible.
“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 looked at each other. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I was able. I would become a mother.”
Methods to address babies with exposure have been used for a long time.
The evaluation method was developed in 1975|
