Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had built in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
Five days later, on 12 November 2022, Stephanie had a baby girl weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she failed. She felt worthless, berating herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to monitors, so tiny she thought she would harm her. Cradling her initially, she felt nothing. “I just stared 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 call her daughter after her caregiver, after the professional who provided support to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when families are kept intact, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to pick her up.
She departed the institution still in recovery, fearful and unsure about what would follow.
At the facility, 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 take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to let her down. She lacked the ability to care for herself, much less anyone else.
Every day, staff from the facility took her to a treatment center, provided orally. Over time, she was starting to get clean.
She devoted all her time outside treatment 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 severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a peer support specialist, visited with her own five kids in tow to drop off cookies. They all assembled beside 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. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo 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 entryway at her back. She is slender. Her head is tilted forward so you miss her features. She is lifting the baby on her lap for the children to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have existed for decades.
The assessment tool was created in 1975|
