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 went to the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had four weeks left to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to 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 infant weighing a small weight – premature, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she failed. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her dealer would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her recover only led to increased guilt and self-abuse, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was connected to tubes and leads, so small she thought she would break her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is identified with infant withdrawal condition regularly, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when parents and infants remain united, results get better, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, care providers came to collect her.
She departed the institution still in detox, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could walk in and separate them.
For the first two weeks, 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 enduring. Substances came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She did not know how to value herself, not to mention anyone else.
Every day, staff from Maddie’s Place took her to a treatment center, administered in pill form. Gradually, she was embracing sobriety.
She devoted all her time 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 adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a peer support specialist, visited with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground 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. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a beanie with a decoration on her head, seated on the ground with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is holding Izzie up on her lap for the young ones to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion 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 be a mom.”
Tools for treating babies with exposure have existed for decades.
The evaluation method was created in 1975|
