She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” 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 walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – premature, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was detached. Her epidural had failed, her final administration of fentanyl had been administered shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she was unsuccessful. She felt without value, criticizing herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her source declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her quit only led to deeper self-loathing and self-abuse, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to monitors, so small she thought she would break her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain 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.
Medical personnel told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when parents and infants remain united, outcomes improve, fewer children enter care 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 left the medical center still in detox, fearful and unsure about what would follow.
At the facility, Stephanie still worried that child services would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could enter and separate them.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to let her down. She did not know how to care for herself, much less anyone else.
Daily, staff from the center drove her to a treatment center, provided orally. Gradually, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – all frequent conditions 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.
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. A support specialist, a mentor, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, seated on the ground with the door behind her. She is thin. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I would become a mother.”
Methods to address babies with exposure have been used for a long time.
The evaluation method was developed in 1975|
