Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she had to return to get high again. She thought she still had four weeks left to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on 12 November 2022, Stephanie had a baby girl weighing a small weight – early, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been administered shortly before she gave birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she failed. She felt without value, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her stop using only led to greater shame and self-abuse, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the NICU. When Stephanie at last met her, she was hooked up to medical equipment, so small she thought she would harm her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Nurses and doctors 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 diagnosed with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a developing system of centers like this facility is demonstrating a key fact: when parents and infants remain united, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and separate them.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, 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 cause pain. She was unable to love herself, not to mention anyone else.
Each day, staff from the center transported her to a recovery program, given as medication. Slowly, she was embracing sobriety.
She devoted all her time 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 adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, visited with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her posture is humble so you cannot see her face. She is presenting her daughter on her lap for the children to see and they are gathered around, admiring and touching to the baby.
A young boy, 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 possible.
“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 her companion exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I found the courage. I could parent.”
Tools for treating infants affected by substances have been available for years.
The Finnegan NAS scale was established in 1975|
