Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at 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 acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she had to return to relapse. She thought she still had a month remaining to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, 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 every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a daughter weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she relapsed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her source refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her affection for her child would make her recover only led to deeper self-loathing 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 overcome a long-term illness.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so little she thought she would harm her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition regularly, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a developing system of centers like the care home is showing an important truth: when parents and infants remain united, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would come next.
At the care center, Stephanie still feared that child services would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Substances came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to hurt her. She did not know how to value herself, let alone anyone else.
Each day, staff from the center drove her to a recovery program, provided orally. Over time, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an professional – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, came over with her own five kids in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in black pants and a hoodie, a beanie with a decoration on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you do not see her expression. She is holding Izzie up on her lap for the other kids to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The parents responded 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 her companion made eye contact. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I found the courage. I could be a mom.”
Approaches for managing infants affected by substances have been used for a long time.
The evaluation method was created in 1975|
