A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the medical facility after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie eventually collapsed. “I have to get out of here. 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 was compelled to leave to relapse. She thought she still had several weeks to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
After five days, on a day in November 2022, Stephanie had a baby girl weighing 4lb 8oz – born before term, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her pain relief did not work, her final administration of fentanyl had been administered shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she was unsuccessful. She felt worthless, blaming herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her source declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her stop using only led to greater shame and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the NICU. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would harm her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period 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 Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like the care home is demonstrating a key fact: when parents and infants remain united, results get better, 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 stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could enter and separate them.
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 enduring. Addiction came first; faith 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 did not know how to care for herself, not to mention anyone else.
Each day, staff from Maddie’s Place drove her to a clinic for methadone, given as medication. Over time, 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 girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. 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 monitored interactions with their babies. A support specialist, a recovery coach, visited with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, sitting on the wooden floor with the exit nearby. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the young ones to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the moms: “Where are all the dads?” The moms tried to explain 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. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
