She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.

Eight months pregnant and in severe pain, Stephanie Rosell arrived at the medical facility after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she lived in a shed she had built in a acquaintance's garden. She was also addicted to fentanyl.

As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and became sick.

Stephanie finally broke down. “Listen, I gotta go. I have to go home and take a hit.”

She had consumed opioids before seeking medical help and had only a brief window to get treated before she had to return to relapse. She thought she still had a month remaining to find a way to become sober and deliver her child.

The nurse had other ideas. She told Stephanie she was staying put.

“Yes, I am,” Stephanie said.

But the doctors would not let her go: the condition in her limbs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.

She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that abstinence might harm 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.

A short time later, on the 12th of November, Stephanie gave birth to a infant weighing a small weight – born before term, tiny yet healthy.

When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided shortly before she gave birth.

She felt sick. Not ready for motherhood. Undeserving.

Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she failed. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her supplier would not provide to her when she became obviously with child.

“But I couldn’t,” she said. “I needed help.”

The pervasive expectation that her love for her baby would make her recover only led to greater shame and self-harm, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.

The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was connected to medical equipment, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘How will I care for 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 supported as a unit, not apart.

In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is showing an important truth: when parents and infants remain united, outcomes improve, custody cases decrease and overall savings increase.

It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to bring her to the facility.

She departed the institution still in withdrawal, fearful and unsure about what would follow.

At the facility, Stephanie still feared that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could enter and take her baby away.

For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”

Homelessness, she said, was about survival. Addiction came first; reliance came last.

Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to cause pain. She was unable to love herself, much less anyone else.

Every day, staff from the facility transported her to a treatment center, given as medication. Over time, she was embracing sobriety.

She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all common issues 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.

On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, came over with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.

The young ones stared in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”

She keeps a photo of the moment. She is dressed in black pants and a hoodie, a cap with a decoration on her head, sitting on the wooden floor with the exit nearby. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her knee for the young ones to see and they are gathered around, fawning and reaching out to the baby.

A young boy, eight, asked the moms: “Why are there no men?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there given the chance.

“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”

Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could parent.”

Methods to address babies with exposure have been available for years.

The Finnegan NAS scale was developed in 1975|