She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the hospital emergency room after an infection began spreading up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she needed to go home to use once more. She thought she still had four weeks left to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
After five days, on a day in November 2022, Stephanie had a baby girl weighing a small weight – early, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been provided a few hours prior to birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she failed. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her supplier would not provide to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her love for her baby would make her quit only led to greater shame and self-abuse, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, so small she thought she would harm her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a unique recovery environment where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is found to have infant withdrawal condition frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would happen next.
At the facility, Stephanie still worried that child services would come take Izzie – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could walk in 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 lacked confidence at that point.”
Life on the streets, she said, was about survival. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to let her down. She lacked the ability to love herself, much less anyone else.
Daily, staff from the facility transported her to a recovery program, given as medication. Over time, she was beginning recovery.
She devoted all her time when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a recovery coach, came over with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in admiration of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is wearing black pants and a hoodie, a cap with a pompom on her head, seated on the ground with the exit nearby. She is slender. Her head is tilted forward so you cannot see her face. She is lifting the baby on her leg for the other kids to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I found the courage. I would become a mother.”
Tools for treating infants affected by substances have been used for a long time.
The assessment tool was developed in 1975|
