A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had built in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had consumed opioids 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 attending nurse disagreed. 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 serious, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
After five days, on a day in November 2022, Stephanie gave birth to a baby girl weighing a small weight – born before term, small but alive.
When the caregiver questioned 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 given a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she relapsed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her stop using only led to increased guilt and self-harm, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was connected to tubes and leads, so little she thought she would hurt her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a new kind of care center where women and their babies are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when parents and infants remain united, results get better, custody cases decrease and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to collect her.
She departed the institution still in detox, scared and uncertain about what would follow.
At the care center, Stephanie still worried that child services would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could walk in and remove her child.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Drugs came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to let her down. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from Maddie’s Place drove her to a clinic for methadone, administered in pill form. Gradually, she was starting to get clean.
She devoted all her time outside treatment 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 severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own children in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in casual attire, a gray knit hat with a decoration on her head, seated on the ground with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her lap for the young ones to see and they are standing close, showing interest to the baby.
One child, eight, asked the moms: “Why are there no men?” The moms tried to explain that the men were occupied, 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 made eye contact. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was established in 1975|
