She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had built in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before seeking medical help 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 plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, 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 face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, 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 frequently utilized in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a infant weighing a small weight – early, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her final administration of fentanyl had been provided a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her source would not provide to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and self-abuse, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was connected to medical equipment, so tiny she thought she would break her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with 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 this facility is showing an important truth: when parents and infants remain united, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to collect her.
She stepped out of the hospital still in recovery, fearful and unsure about what would come next.
At the care center, Stephanie still worried that authorities would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could enter and separate them.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Addiction came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to hurt her. She was unable to value herself, not to mention anyone else.
Every day, staff from the center took her to a clinic for methadone, given as medication. Gradually, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an specialist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own children in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo 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 lean. Her head is tilted forward so you miss her features. She is holding Izzie up on her lap for the children to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could be a mom.”
Methods to address drug-exposed newborns have been available for years.
The Finnegan NAS scale was established in 1975|
