Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had constructed in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I have to get out of here. 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 was compelled to leave to get high again. She thought she still had four weeks left to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, 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 withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
After five days, on the 12th of November, Stephanie had a baby girl weighing just over four pounds – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she failed. She felt worthless, blaming herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her supplier would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her quit only led to deeper self-loathing and negative self-talk, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the NICU. When Stephanie at last met her, she was connected to medical equipment, so small she thought she would break her. Cradling her initially, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where women and their babies are treated together, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, results get better, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, care providers came to bring her to the facility.
She departed the institution still in withdrawal, fearful and unsure about what would happen next.
At the care center, Stephanie still worried that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could walk in and separate them.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to hurt her. She lacked the ability to care for herself, much less anyone else.
Every day, staff from Maddie’s Place took her to a treatment center, given as medication. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an professional – all typical problems 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.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. An advocate, a peer support specialist, came over with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, resting on the floor with the door behind her. She is thin. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the children to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could parent.”
Methods to address babies with exposure have been used for a long time.
The Finnegan NAS scale was developed in 1975|