She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the ER after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had assembled in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had just enough time to get treated before she needed to go home to use once more. She thought she still had a month remaining to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in substance abuse treatment.
Five days later, on the 12th of November, Stephanie delivered a infant weighing just over four pounds – born before term, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she was unsuccessful. She felt worthless, berating herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her affection for her child would make her quit only led to deeper self-loathing and self-abuse, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to medical equipment, so small she thought she would break her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the professional who provided support to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In many parts of America, 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 small, growing network of centers like the care home is showing an important truth: when mothers and babies stay together, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After confirming she would be a good fit for the program, care providers came to collect her.
She departed the institution still in recovery, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still feared that CPS would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could walk in and separate them.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Drugs came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to value herself, much less anyone else.
Each day, staff from the center transported her to a treatment center, given as medication. Over time, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is clad in casual attire, a cap with a pompom on her head, sitting on the wooden floor with the exit nearby. She is lean. Her head is tilted forward so you miss her features. She is presenting her daughter on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The women attempted to clarify 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 broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could parent.”
Tools for treating babies with exposure have been available for years.
The assessment tool was established in 1975|
