She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had a month remaining to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
After five days, on the 12th of November, Stephanie delivered a daughter weighing 4lb 8oz – premature, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The widespread belief that her love for her baby would make her recover only led to greater shame and negative self-talk, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to monitors, so little she thought she would hurt her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition regularly, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to collect her.
She departed the institution still in recovery, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any time, someone could walk in and take her baby away.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Substances came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to let her down. She was unable to care for herself, not to mention anyone else.
Each day, staff from the facility transported her to a recovery program, administered in pill form. Slowly, she was embracing sobriety.
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 sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own five kids in tow to bring treats. They all assembled beside 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 has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her face is downcast so you do not see her expression. She is presenting her daughter on her knee for the other kids to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the men were occupied, called away to other tasks, 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 just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could be a mom.”
Tools for treating drug-exposed newborns have been used for a long time.
The assessment tool was established in 1975|
