Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.

In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had assembled in a companion's property. She was also addicted to fentanyl.

As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and vomited.

Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”

She had consumed opioids before coming to the ER and had only a brief window to get treated before she needed to go home to get high again. She thought she still had four weeks left 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 hospital refused to discharge her: the infection in her legs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named 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 every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.

After five days, on the 12th of November, Stephanie had a infant weighing a small weight – premature, small but alive.

When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.

She felt unwell. Not ready for motherhood. Unworthy.

Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.

“However, I failed,” she said. “I had to seek support.”

The pervasive expectation that her affection for her child would make her quit only led to greater shame and negative self-talk, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.

The infant was moved to the neonatal intensive care unit. When Stephanie at last met her, she was connected to tubes and leads, so small she thought she would break her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.

After two days she decided to name her baby Izzie, after the attendant who showed compassion to her.

Medical personnel told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.

In many parts of America, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is proving a simple point: when families are kept intact, results get better, custody cases decrease and overall savings increase.

It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to collect her.

She departed the institution still in detox, scared and uncertain about what would come next.

At the care center, Stephanie still worried that child services would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and separate them.

For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”

Survival outdoors, she said, was about getting by. Addiction came first; reliance came last.

Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She was unable to care for herself, let alone anyone else.

Every day, staff from Maddie’s Place drove her to a recovery program, given as medication. Slowly, she was embracing sobriety.

She spent every minute 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 nutritional guidance. She also had increased sensitivity and required an specialist – all frequent conditions for babies exposed to substances.

When a child recognizes these infants need affection, then I found the strength. I could be a mom.

During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, visited with her own five kids in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.

The children were wide-eyed in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”

She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a cap with a pompom on her head, sitting on the wooden floor with the door behind her. She is thin. Her face is downcast so you miss her features. She is presenting her daughter on her knee for the young ones to see and they are crowding near, fawning and reaching out to the baby.

A young boy, eight, asked the moms: “Why are there no men?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there given the chance.

“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”

Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.”

Methods to address infants affected by substances have been used for a long time.

The evaluation method was developed in 1975|