She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell visited the ER after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
After five days, on the 12th of November, Stephanie delivered a baby girl weighing just over four pounds – early, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The widespread belief that her love for her baby would make her quit only led to deeper self-loathing 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 chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to monitors, so small she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where women and their babies are treated together, not apart.
In numerous states, where a baby is identified with infant withdrawal condition frequently, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She departed the institution still in withdrawal, fearful and unsure about what would follow.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could arrive and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She was unable to value herself, let alone anyone else.
Daily, staff from Maddie’s Place transported her to a clinic for methadone, provided orally. Slowly, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an specialist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. An advocate, a mentor, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They were innocent,” 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 dressed in casual attire, a cap with a decoration on her head, seated on the ground with the door behind her. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her lap for the children to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the mothers: “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.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could be a mom.”
Approaches for managing drug-exposed newborns have existed for decades.
The assessment tool was established in 1975|
