Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell visited the medical facility after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had built in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had consumed opioids before seeking medical help and had sufficient opportunity to get treated before she needed to go home to use once more. 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 allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
Five days later, on the 12th of November, Stephanie gave birth to a daughter weighing just over four pounds – premature, tiny yet healthy.
When the nurse asked 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 provided a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she was unsuccessful. She felt without value, berating herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her source declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her stop using only led to increased guilt and self-abuse, a cause for her to use again. Yet she could not just wish 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 little she thought she would hurt her. Embracing her at last, she felt detached. “I just stared at 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 a specialized facility, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In much of the US, where a baby is found to have infant withdrawal condition regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like this facility is proving a simple point: when families are kept intact, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in detox, fearful and unsure about what would follow.
At the care center, Stephanie still was concerned that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could arrive and take her baby away.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She did not know how to love herself, much less anyone else.
Daily, staff from the center took her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She spent every minute beyond therapy 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 nutritional guidance. She also had heightened sensory issues and required an professional – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for guided meetings with their babies. A support specialist, a peer support specialist, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the tiny infant 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 dressed in black pants and a hoodie, a gray knit hat with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her lap for the other kids to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the parents: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address babies with exposure have been used for a long time.
The Finnegan NAS scale was developed in 1975|
