She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had built in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but physicians found she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie had a infant weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, berating herself for not being able to overcome the challenge. An OBGYN told her to “only” stop using. Even her dealer would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her quit only led to deeper self-loathing 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 eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie finally saw her 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 looked at 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 give her child the name the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: when families are kept intact, results get better, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She left the medical center still in withdrawal, scared and uncertain about what would happen next.
At the facility, Stephanie still was concerned that CPS would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “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.”
Life on the streets, she said, was about survival. Substances came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to let her down. She was unable to love herself, let alone anyone else.
Each day, staff from the center drove her to a clinic for methadone, administered in pill form. Over time, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, visited with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing casual attire, a cap with a bobble on her head, sitting on the wooden floor with the exit nearby. She is slender. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her knee for the young ones to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the parents: “Why are there no men?” The parents responded that the dads were busy, engaged elsewhere, 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 Bunch-Smith 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 could do this. I would become a mother.”
Methods to address babies with exposure have been used for a long time.
The Finnegan NAS scale was developed in 1975|
