She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had taken the drug before coming to the ER and had just enough time to get treated before she needed to go home to use once more. She thought she still had a month remaining 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 will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie measured quantities 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.
A short time later, on the 12th of November, Stephanie gave birth to a infant weighing just over four pounds – premature, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she failed. She felt hopeless, berating herself for not being able to achieve the unattainable. An OBGYN 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 needed help.”
The pervasive expectation that her affection for her child would make her quit only led to deeper self-loathing and self-harm, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was hooked up to medical equipment, so small she thought she would hurt her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition regularly, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a small, growing network of centers like the care home is proving a simple point: when families are kept intact, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, anxious and doubtful about what would follow.
At the facility, Stephanie still worried that child services would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any point, someone could arrive and remove her child.
For the first two weeks, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Addiction came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to cause pain. She lacked the ability to value herself, let alone anyone else.
Every day, staff from the center drove her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a mentor, came over with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe 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 keeps a photo of the moment. She is wearing black pants and a hoodie, a cap with a bobble on her head, seated on the ground with the exit nearby. She is lean. Her head is tilted forward so you miss her features. She is holding Izzie up on her lap for the other kids to see and they are standing close, showing interest to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I found the courage. I could parent.”
Methods to address babies with exposure have been available for years.
The Finnegan NAS scale was developed in 1975|
