She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell went to the ER after her infection worsened up her legs. Without a job or home, separated from loved ones, she lived in a shed she had constructed in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she had to return to use once more. She thought she still had a month remaining to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
Five days later, on 12 November 2022, Stephanie had a infant weighing 4lb 8oz – born before term, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt without value, blaming herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her love for her baby would make her stop using only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was hooked up to monitors, so little she thought she would harm her. Cradling her initially, she felt detached. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the professional who provided support to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.
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 bring her to the facility.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would come next.
At the facility, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could arrive and remove her child.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about getting by. Substances came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to value herself, much less anyone else.
Each day, staff from Maddie’s Place transported her to a treatment center, administered in pill form. Slowly, she was beginning recovery.
She devoted all her time beyond therapy 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 obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an specialist – all common issues 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 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 mentor, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her leg for the other kids to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The parents responded that the men were occupied, engaged elsewhere, 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’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith 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 parent.”
Methods to address babies with exposure have been available for years.
The Finnegan NAS scale was developed in 1975|
