Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had constructed in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
Five days later, on the 12th of November, Stephanie gave birth to a infant weighing 4lb 8oz – early, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been given a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she failed. She felt without value, blaming herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her recover only led to increased guilt and negative self-talk, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to monitors, so little she thought she would break her. Embracing her at last, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a developing system of centers like this facility is showing an important truth: when families are kept intact, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She departed the institution still in withdrawal, scared and uncertain about what would happen next.
At the care center, Stephanie still was concerned that CPS would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: 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 lacked confidence at that point.”
Life on the streets, she said, was about survival. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to let her down. She did not know how to love herself, not to mention anyone else.
Every day, staff from the center took her to a treatment center, provided orally. Over time, she was beginning recovery.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an professional – all frequent conditions for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions 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 resting on the carpet holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the exit nearby. She is slender. Her posture is humble so you miss her features. She is lifting the baby on her knee for the children to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, 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 looked at each other. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I would become a mother.”
Methods to address drug-exposed newborns have been used for a long time.
The evaluation method was established in 1975|
