Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the ER 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 built in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she needed to go home to relapse. She thought she still had several weeks to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a baby girl weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her pain relief did not work, her last dose of fentanyl had been given a few hours prior to birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she failed. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and negative self-talk, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie at last met her, she was hooked up to tubes and leads, so small she thought she would harm her. Embracing her at last, she felt empty. “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 after her caregiver, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms regularly, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to collect her.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still feared that CPS would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could enter and separate them.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She lacked the ability to value herself, let alone anyone else.
Each day, staff from the center took her to a clinic for methadone, provided orally. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – all typical problems 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 parents in active addiction can come for supervised visits 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 young ones stared in wonder of the tiny infant 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 has an image of the moment. She is wearing black pants and a hoodie, a beanie with a bobble on her head, sitting on the wooden floor with the exit nearby. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her lap for the other kids to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I could be a mom.”
Approaches for managing babies with exposure have existed for decades.
The Finnegan NAS scale was created in 1975|
