A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the ER after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had constructed in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she had to return to relapse. She thought she still had four weeks left to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie delivered a infant weighing just over four pounds – premature, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her final administration of fentanyl had been provided a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she failed. She felt hopeless, berating herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her stop using only led to deeper self-loathing and negative self-talk, a trigger for her to use again. 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 connected to tubes and leads, so tiny she thought she would hurt her. Embracing her at last, she felt detached. “I looked at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the professional who provided support 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 much of the US, where a baby is found to have infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a developing system of centers like the care home is proving a simple point: when families are kept intact, recovery succeeds, foster placements fall 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 pick her up.
She departed the institution still in withdrawal, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could enter and remove her child.
For the first two weeks, Stephanie remained isolated. “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 getting by. Drugs came first; faith 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 did not know how to care for herself, much less anyone else.
Daily, staff from Maddie’s Place drove her to a recovery program, provided orally. Slowly, she was beginning recovery.
She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an professional – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, came over with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her lap for the young ones to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was created in 1975|