Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, 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 rehabilitation.
Five days later, on a day in November 2022, Stephanie had a baby girl weighing just over four pounds – born before term, 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 final administration of fentanyl had been administered four hours before delivery.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she was unsuccessful. She felt worthless, criticizing herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her supplier declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her love for her baby would make her quit only led to deeper self-loathing and negative self-talk, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to monitors, so small she thought she would break her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, 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 showing an important truth: when parents and infants remain united, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter 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 didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to let her down. She lacked the ability to care for herself, let alone anyone else.
Each day, staff from Maddie’s Place drove her to a clinic for methadone, provided orally. Over time, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had sensory challenges 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 remained in the shared space, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, visited with her own family in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in casual attire, a beanie with a decoration on her head, seated on the ground with the entryway at her back. She is thin. Her face is downcast so you cannot see her face. She is holding Izzie up on her leg for the young ones to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “Why are there no men?” The parents responded that the men were occupied, handling responsibilities, that they would be there if they could.
“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 exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could parent.”
Tools for treating drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was developed in 1975|
