She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.

In her eighth month of pregnancy and suffering, Stephanie Rosell visited the hospital emergency room 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 companion's property. She was also dependent on fentanyl.

As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. 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 taken the drug before coming to the ER and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to figure out how to get clean and deliver her child.

The nurse had other ideas. She told Stephanie she was not allowed to leave.

“I will go,” Stephanie said.

But the medical facility declined to release her: the condition in her limbs 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 be at risk of death.

The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in addiction recovery.

Five days later, on the 12th of November, Stephanie had a baby girl weighing just over four pounds – early, little but surviving.

When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her epidural had failed, her previous intake of fentanyl had been given shortly before she gave birth.

She felt unwell. Unprepared to be a mother. Unworthy.

Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became visibly pregnant.

“However, I failed,” she said. “I had to seek support.”

The common assumption that her affection for her child would make her recover only led to greater shame and self-abuse, a impetus for her to relapse. Yet she could not just wish 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 attached to tubes and leads, so little she thought she would harm her. Cradling her initially, she felt empty. “I just stared 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 give her child the name after her caregiver, after the attendant who showed compassion to her.

Medical personnel told her about a specialized facility, a innovative treatment home where women and their babies are supported as a unit, not apart.

In much of the US, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, recovery succeeds, foster placements fall and future expenses reduce.

It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to pick her up.

She departed the institution still in recovery, anxious and doubtful about what would happen next.

At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could arrive and take her baby away.

For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”

Life on the streets, she said, was about enduring. Drugs came first; faith came last.

Stephanie had one close friend, but even that bond was fragile. 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 the facility transported her to a recovery program, administered in pill form. Over time, she was embracing sobriety.

She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges 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 could be a mom.

During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a peer support specialist, visited with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.

The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”

She keeps a photo of the moment. She is wearing black pants and a hoodie, a cap with a decoration on her head, seated on the ground with the entryway at her back. She is slender. 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 gathered around, fawning and reaching out to the baby.

Jacob, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the dads were busy, called away to other tasks, that they would be there if they could.

“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 the specialist looked at each other. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could be a mom.”

Tools for treating drug-exposed newborns have been used for a long time.

The evaluation method was developed in 1975|