She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had assembled in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
After five days, on the 12th of November, Stephanie delivered a infant weighing just over four pounds – born before term, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful 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 supplier refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her quit only led to deeper self-loathing and self-abuse, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to name her baby Izzie, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home 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 neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and medicated while their mothers face parental assessments. But a small, growing network of centers like this facility is proving a simple point: when families are kept intact, recovery succeeds, custody cases decrease 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, two staff members came to pick her up.
She departed the institution still in recovery, scared and uncertain about what would happen next.
At the care center, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and separate them.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Addiction came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to care for herself, let alone anyone else.
Daily, staff from the center drove her to a treatment center, provided orally. Slowly, she was starting to get clean.
She spent every minute 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 sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an professional – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her lap 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 dads were busy, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I was able. I would become a mother.”
Approaches for managing infants affected by substances have been available for years.
The assessment tool was developed in 1975|
