She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had constructed in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. 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 consumed opioids before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
A short time later, on the 12th of November, Stephanie had a baby girl weighing just over four pounds – born before term, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been provided shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she relapsed. She felt without value, berating herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her stop using only led to greater shame and self-harm, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would hurt her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like this facility is proving a simple point: when families are kept intact, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to collect her.
She departed the institution still in detox, fearful and unsure about what would follow.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Drugs came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She lacked the ability to care for herself, not to mention anyone else.
Every day, staff from Maddie’s Place drove her to a clinic for methadone, given as medication. Gradually, 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 infant faced feeding challenges at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you do not see her expression. She is presenting her daughter on her leg for the young ones to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I would become a mother.”
Methods to address infants affected by substances have been used for a long time.
The evaluation method was developed in 1975|
