She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the ER after an infection began spreading up her legs. Without a job or home, estranged from her family, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. 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 use drugs.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she had to return to use once more. She thought she still had several weeks to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
Izzie persuaded 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 transitioned to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
Five days later, on the 12th of November, Stephanie had a baby girl weighing 4lb 8oz – born before term, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her quit only led to greater shame and negative self-talk, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would break her. Holding her for the first time, she felt empty. “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.
After two days she decided to call her daughter after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a new kind of care center where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, care providers came to collect her.
She left the medical center still in recovery, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any time, someone could walk in and separate them.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to cause pain. She was unable to love herself, let alone anyone else.
Each day, staff from the facility took her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is wearing black pants and a hoodie, 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 face is downcast so you miss her features. She is lifting the baby on her leg for the other kids to see and they are crowding near, admiring and touching to the baby.
One child, 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.
“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, 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|
