Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she needed to go home to get high again. She thought she still had a month remaining to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
After five days, on 12 November 2022, Stephanie gave birth to a daughter weighing a small weight – premature, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her epidural had failed, her previous intake of fentanyl had been given a few hours prior to birth.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she was unsuccessful. She felt worthless, blaming herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her source would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her quit only led to increased guilt and self-abuse, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was hooked up to tubes and leads, so little she thought she would hurt her. Embracing her at last, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the professional who provided support to her.
Medical personnel told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is found to have newborn addiction symptoms 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 the care home is proving a simple point: when parents and infants remain united, outcomes improve, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She left the medical center still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could arrive and take her baby away.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Substances came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She lacked the ability to value herself, much less anyone else.
Daily, staff from the facility drove her to a treatment center, administered in pill form. Over time, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support 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 heightened sensory issues and required an specialist – all typical problems for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a recovery coach, came over with her own five kids in tow to deliver baked goods. 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 didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is clad in black pants and a hoodie, a cap with a pompom on her head, resting on the floor with the door behind her. She is lean. Her face is downcast so you cannot see her face. She is lifting the baby on her lap for the young ones to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the moms: “Why are there no men?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “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.”
Tools for treating infants affected by substances have been used for a long time.
The evaluation method was created in 1975|
