She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
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, separated from loved ones, she stayed in a makeshift shelter she had built in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She slumped forward and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had a month remaining to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
Five days later, on the 12th of November, Stephanie delivered a infant weighing just over four pounds – born before term, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she failed. She felt worthless, criticizing herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her source refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her love for her baby would make her recover only led to greater shame and self-abuse, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was hooked up to monitors, so small she thought she would break her. Cradling her initially, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the professional who provided support 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 neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is proving a simple point: when mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would come next.
At the facility, Stephanie still feared that CPS would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could arrive and separate them.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about enduring. Addiction came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She lacked the ability to value herself, let alone anyone else.
Each day, staff from the facility drove her to a clinic for methadone, administered in pill form. Slowly, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all typical problems for babies born with NAS.
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 parents in active addiction can come for monitored interactions with their babies. A support specialist, a recovery coach, stopped by with her own five kids in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They were innocent,” 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 dark trousers and a sweatshirt, a cap with a bobble on her head, seated on the ground with the exit nearby. She is lean. Her face is downcast so you cannot see her face. 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.
One child, eight, asked the parents: “What about the fathers?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I could be a mom.”
Tools for treating drug-exposed newborns have been available for years.
The Finnegan NAS scale was developed in 1975|
