She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell visited the medical facility after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she had to return to get high again. She thought she still had four weeks left to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
After five days, on 12 November 2022, Stephanie gave birth to a baby girl weighing a small weight – early, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered a few hours prior to birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt horrible 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 would not provide to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her recover only led to greater shame and self-abuse, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was attached to medical equipment, so small she thought she would harm her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a innovative treatment home where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is identified with infant withdrawal condition regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when families are kept intact, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still was concerned that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could enter and separate them.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She did not know how to value herself, not to mention anyone else.
Daily, staff from the facility took her to a clinic for methadone, provided orally. Gradually, she was embracing sobriety.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. An advocate, a mentor, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared 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 holds a picture 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 door behind her. She is lean. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the other kids to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the mothers: “Why are there no men?” The parents responded that the men were occupied, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could parent.”
Approaches for managing drug-exposed newborns have existed for decades.
The Finnegan NAS scale was created in 1975|
