She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, 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 resided in a small structure she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a infant weighing a small weight – born before term, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been administered shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she was unsuccessful. She felt worthless, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her dealer would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her stop using only led to increased guilt and negative self-talk, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to medical equipment, so small she thought she would harm her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the professional who provided support to her.
Nurses and doctors told her about a care center, a innovative treatment home where women and their babies are treated together, not apart.
In much of the US, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when parents and infants remain united, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to pick her up.
She departed the institution still in withdrawal, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still worried that CPS would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any point, someone could enter and separate them.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Substances came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to love herself, let alone anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, administered in pill form. Over time, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an specialist – all frequent conditions for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. A support specialist, a mentor, stopped by with her own family in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you cannot see her face. She is lifting the baby on her leg for the children to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have been available for years.
The evaluation method was established in 1975|
