She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had constructed in a friend’s yard. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before seeking medical help and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had four weeks left to find a way to become sober and have this baby.
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 condition in her limbs was serious, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
Five days later, on the 12th of November, Stephanie gave birth to a daughter weighing just over four pounds – premature, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her last dose of fentanyl had been given a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she was unsuccessful. She felt worthless, criticizing herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her supplier refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her recover only led to deeper self-loathing and negative self-talk, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was connected to monitors, so little she thought she would break her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a small, growing network of centers like this facility is proving a simple point: when mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to collect her.
She departed the institution still in detox, anxious and doubtful about what would follow.
At the facility, Stephanie still was concerned that child services would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could arrive and separate them.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Substances came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to let her down. She did not know how to value herself, much less anyone else.
Each day, staff from the center transported 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 infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own family in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is wearing casual attire, a beanie with a decoration on her head, resting on the floor with the entryway at her back. She is thin. Her face is downcast so you cannot see her face. She is lifting the baby on her leg for the children to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I found the courage. I would become a mother.”
Methods to address infants affected by substances have been available for years.
The Finnegan NAS scale was developed in 1975|
