A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after her infection worsened up her legs. Without a job or home, 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 started to feel anxious. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had four weeks left to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
After five days, on the 12th of November, Stephanie had a infant weighing a small weight – premature, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she relapsed. She felt without value, criticizing herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her supplier would not provide to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The common assumption that her love for her baby would make her quit only led to deeper self-loathing and self-abuse, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the NICU. When Stephanie at last met her, she was attached to medical equipment, so small she thought she would break her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the professional who provided support to her.
Medical personnel told her about a specialized facility, a innovative treatment home where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals 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, outcomes improve, custody cases decrease and overall savings increase.
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, care providers came to bring her to the facility.
She left the medical center still in detox, anxious and doubtful about what would come next.
At the care center, Stephanie still worried that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Substances came first; trust came last.
Stephanie had one close friend, 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, let alone anyone else.
Daily, staff from the facility drove her to a treatment center, administered in pill form. Over time, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an specialist – 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 guided meetings with their babies. Katie Bunch-Smith, a recovery coach, visited with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is wearing black pants and a hoodie, a gray knit hat with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her head is tilted forward so you miss her features. She is lifting the baby on her leg for the young ones to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could parent.”
Tools for treating babies with exposure have existed for decades.
The evaluation method was created in 1975|
