Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after an infection began spreading up her legs. Without a job or home, estranged from her family, she resided in a small structure she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she needed to go home to use once more. She thought she still had a month remaining to figure out how to get clean and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
After five days, on a day in November 2022, Stephanie had a infant weighing 4lb 8oz – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her love for her baby would make her quit only led to greater shame and negative self-talk, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the NICU. When Stephanie at last met her, she was hooked up to medical equipment, so little she thought she would harm 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 still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition regularly, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a small, growing network of centers like this facility is proving a simple point: when parents and infants remain united, results get better, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would follow.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could walk in 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 lacked confidence at that point.”
Life on the streets, she said, was about getting by. Substances came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to let her down. She lacked the ability to value herself, not to mention anyone else.
Each day, staff from the facility drove her to a clinic for methadone, administered in pill form. Over time, she was beginning recovery.
She spent every minute 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 sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, visited with her own children in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is dressed in casual attire, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is lifting the baby on her leg for the children to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The parents responded that the men were occupied, handling responsibilities, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I could parent.”
Approaches for managing babies with exposure have been available for years.
The Finnegan NAS scale was created in 1975|
