She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell went to the ER after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had constructed in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before seeking medical help 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 attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, 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 withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
Five days later, on 12 November 2022, Stephanie delivered a daughter weighing 4lb 8oz – early, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she relapsed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her source refused to sell to her when she became clearly expecting.
“However, I failed,” 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 cause for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to medical equipment, so little she thought she would harm her. Embracing her at last, she felt detached. “I just stared 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 after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a new kind of care center where women and their babies are treated together, not apart.
In many parts of America, 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 small, growing network of centers like the care home is showing an important truth: when mothers and babies stay together, results get better, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to pick her up.
She left the medical center still in recovery, anxious and doubtful about what would follow.
At the care center, Stephanie still worried that authorities would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and remove her child.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to let her down. She did not know how to love herself, let alone anyone else.
Each day, staff from the facility drove her to a clinic for methadone, given as medication. Slowly, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an specialist – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own children in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in casual attire, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her head is tilted forward so you miss her features. She is holding Izzie up on her leg for the children to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I would become a mother.”
Approaches for managing infants affected by substances have existed for decades.
The evaluation method was created in 1975|
