She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the ER after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had constructed in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before seeking medical help and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had several weeks to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced 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 substance abuse treatment.
A short time later, on the 12th of November, Stephanie delivered a daughter weighing a small weight – early, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she was unsuccessful. She felt hopeless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her source declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her quit only led to increased guilt and self-harm, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was hooked up to medical equipment, so tiny she thought she would hurt her. Holding her for the first time, she felt nothing. “I looked 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 give her child the name the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a unique recovery environment where women and their babies are treated together, not apart.
In many parts of America, where a baby is found to have newborn addiction symptoms 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 proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She departed the institution still in withdrawal, anxious and doubtful about what would happen next.
At the facility, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any time, someone could arrive and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about enduring. Addiction came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to cause pain. She was unable to care for herself, not to mention anyone else.
Daily, staff from the center drove her to a treatment center, given as medication. Over time, she was starting to get clean.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an professional – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for supervised visits with their babies. A support specialist, a peer support specialist, visited with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is dressed in casual attire, a cap with a pompom on her head, resting on the floor with the exit nearby. She is lean. Her posture is humble so you miss her features. She is lifting the baby on her knee for the other kids to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I could parent.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was developed in 1975|
