Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the medical facility after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had assembled in a friend’s yard. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. 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 arriving at the hospital and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had four weeks left to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
A short time later, on the 12th of November, Stephanie gave birth to a daughter weighing a small weight – early, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, blaming herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to greater shame and self-harm, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so small she thought she would hurt her. Embracing her at last, she felt nothing. “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.
Following a brief period she decided to give her child the name Izzie, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when families are kept intact, results get better, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to collect her.
She left the medical center still in detox, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still worried that child services would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could arrive and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She lacked the ability to care for herself, much less anyone else.
Each day, staff from Maddie’s Place transported her to a treatment center, administered in pill form. Slowly, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an specialist – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. An advocate, a mentor, stopped by with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in casual attire, a gray knit hat with a pompom on her head, seated on the ground with the entryway at her back. She is slender. Her face is downcast so you miss her features. She is lifting the baby on her lap for the children to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the men were occupied, called away to other tasks, 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 Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could parent.”
Methods to address drug-exposed newborns have been available for years.
The Finnegan NAS scale was developed in 1975|
