A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she had to return to get high again. She thought she still had several weeks to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
Five days later, on the 12th of November, Stephanie had a baby girl weighing 4lb 8oz – premature, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she failed. She felt without value, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her stop using only led to increased guilt and self-harm, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The infant was moved to the NICU. When Stephanie eventually visited 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 is our future?’” She remained uncertain 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.
Hospital staff told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like the care home is showing an important truth: when mothers and babies stay together, results get better, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, care providers came to bring her to the facility.
She departed the institution still in recovery, scared and uncertain about what would happen next.
At the facility, Stephanie still feared that authorities would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to love herself, much less anyone else.
Daily, staff from the center transported her to a clinic for methadone, administered in pill form. Over time, she was starting to get clean.
She utilized each moment outside treatment 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 feeding therapy. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. 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 family in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a bobble on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the other kids to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the dads were busy, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I was able. I could parent.”
Methods to address babies with exposure have been available for years.
The Finnegan NAS scale was established in 1975|
