She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had built in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had consumed opioids before coming to the ER and had only a brief window to get treated before she needed to go home to use once more. She thought she still had a month remaining to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was critical, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
Five days later, on the 12th of November, Stephanie had a infant weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been provided four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she relapsed. She felt worthless, criticizing herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her supplier would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her recover only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the NICU. When Stephanie finally saw her her, she was hooked up to monitors, so little she thought she would break her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, recovery succeeds, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in recovery, fearful and unsure about what would come next.
At the care center, Stephanie still worried that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to cause pain. She lacked the ability to love herself, not to mention anyone else.
Daily, staff from Maddie’s Place transported her to a clinic for methadone, given as medication. Gradually, she was beginning recovery.
She spent every minute 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 intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction 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 crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe 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 holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her face is downcast so you miss her features. She is lifting the baby on her knee for the children to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if they could.
“Once I become a parent,” 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 exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I would become a mother.”
Approaches for managing infants affected by substances have existed for decades.
The evaluation method was established in 1975|
