She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell went to the ER after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she lived in a shed 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 slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she had to return to get high again. She thought she still had a month remaining to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
A short time later, on the 12th of November, Stephanie had a infant weighing 4lb 8oz – born before term, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she failed. She felt without value, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her source declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her stop using only led to increased guilt and negative self-talk, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so little she thought she would break her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition frequently, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is proving a simple point: when families are kept intact, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that CPS would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could arrive and remove her child.
For the first two weeks, 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. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to care for herself, not to mention anyone else.
Daily, staff from Maddie’s Place drove her to a treatment center, administered in pill form. Slowly, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care 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 sensory challenges and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I could parent.
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 mentor, stopped by with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is wearing black pants and a hoodie, a cap with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her head is tilted forward so you miss her features. She is lifting the baby on her knee for the children to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could parent.”
Methods to address infants affected by substances have been available for years.
The Finnegan NAS scale was created in 1975|
