Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell visited the hospital emergency room after her infection worsened up her legs. Without a job or home, estranged from her family, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug 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 a month remaining to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
Five days later, on the 12th of November, Stephanie gave birth to a daughter weighing a small weight – early, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her final administration of fentanyl had been given four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she relapsed. She felt without value, berating herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and self-harm, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to medical equipment, so tiny she thought she would break her. Cradling her initially, she felt nothing. “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 name her baby Izzie, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is identified with infant withdrawal condition frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, results get better, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to pick her up.
She left the medical center still in detox, anxious and doubtful about what would follow.
At the facility, Stephanie still was concerned that authorities would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could enter and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Every day, staff from the center drove her to a recovery program, administered in pill form. Slowly, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an occupational therapist – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own family in tow to drop off cookies. They all crowded near 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. None of those things mattered to them.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a decoration on her head, seated on the ground with the entryway at her back. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her lap for the other kids to see and they are crowding near, showing interest to the baby.
One child, eight, asked the parents: “Why are there no men?” The parents responded that the men were occupied, handling responsibilities, that they would be there given the chance.
“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 Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I could be a mom.”
Approaches for managing babies with exposure have been used for a long time.
The evaluation method was established in 1975|
