Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward 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 get high again. She thought she still had a month remaining to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
Five days later, on the 12th of November, Stephanie delivered a infant weighing 4lb 8oz – early, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she was unsuccessful. She felt hopeless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her source would not provide to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her stop using only led to greater shame and self-abuse, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was connected to tubes and leads, so tiny she thought she would break her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, results get better, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Drugs came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to value herself, not to mention anyone else.
Each day, staff from the facility transported her to a recovery program, given as medication. Slowly, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an specialist – all typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. An advocate, a recovery coach, came over with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is dressed in casual attire, a beanie with a bobble on her head, seated on the ground with the exit nearby. She is thin. 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 standing close, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I could parent.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was established in 1975|
