She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug 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 several weeks to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on 12 November 2022, Stephanie had a infant weighing 4lb 8oz – premature, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been provided a few hours prior to birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she was unsuccessful. She felt without value, berating herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her supplier would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief 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 overcome a persistent condition.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to monitors, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a new kind of care center where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) 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 the care home is demonstrating a key fact: when families are kept intact, results get better, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to pick her up.
She departed the institution still in recovery, fearful and unsure about what would follow.
At the facility, Stephanie still was concerned that child services would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could arrive and remove her child.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Substances came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to value herself, much less anyone else.
Daily, staff from Maddie’s Place took her to a recovery program, provided orally. Over time, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration 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 wearing black pants and a hoodie, a beanie with a pompom on her head, seated on the ground with the door behind her. She is slender. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her lap for the other kids to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, called away to other tasks, 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 will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could be a mom.”
Methods to address drug-exposed newborns have been available for years.
The evaluation method was created in 1975|
