She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell went to the medical facility after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to get high again. 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 staying put.
“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 left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
A short time later, on the 12th of November, Stephanie delivered a daughter weighing just over four pounds – early, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her source would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her stop using only led to increased guilt 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 long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to medical equipment, so little she thought she would hurt her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like this facility is demonstrating a key fact: when mothers and babies stay together, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to collect her.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still was concerned that CPS would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could walk in and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Addiction came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She was unable to care for herself, not to mention anyone else.
Every day, staff from the facility drove her to a clinic for methadone, provided orally. Gradually, she was embracing sobriety.
She devoted all her time beyond therapy 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 dietary support. She also had increased sensitivity and required an occupational therapist – all common issues for babies exposed to substances.
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 remained in the shared space, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a bobble on her head, seated on the ground with the exit nearby. She is thin. Her face is downcast so you miss her features. She is presenting her daughter on her lap for the young ones to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The parents responded that the men were occupied, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could parent.”
Tools for treating babies with exposure have existed for decades.
The evaluation method was created in 1975|
