Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had just enough time to get treated before she needed to go home to get high again. She thought she still had several weeks 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 condition in her limbs was severe, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
After five days, on the 12th of November, Stephanie had a infant weighing a small weight – premature, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her previous intake of fentanyl had been given shortly before she gave birth.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she was unsuccessful. She felt without value, criticizing herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her stop using only led to deeper self-loathing and self-harm, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would harm her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, recovery succeeds, foster placements fall and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, care providers came to collect her.
She stepped out of the hospital still in recovery, scared and uncertain about what would come next.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could arrive and remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Drugs came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She did not know how to care for herself, not to mention anyone else.
Each day, staff from the facility took her to a clinic for methadone, administered in pill form. Gradually, she was starting to get clean.
She utilized each moment 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 intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an professional – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. A support specialist, a recovery coach, came over with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a pompom on her head, seated on the ground with the exit nearby. She is slender. Her face is downcast so you do not see her expression. She is lifting the baby on her leg for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the parents: “What about the fathers?” The parents responded that the dads were busy, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I would become a mother.”
Tools for treating infants affected by substances have been used for a long time.
The Finnegan NAS scale was established in 1975|
