A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell visited the hospital emergency room after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had built in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had used fentanyl before coming to the ER and had just enough time to get treated before she had to return to relapse. She thought she still had several weeks to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie had a baby girl weighing just over four pounds – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she was unsuccessful. She felt hopeless, blaming herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her love for her baby would make her recover only led to greater shame and negative self-talk, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the special care nursery. When Stephanie at last met her, she was hooked up to medical equipment, so little she thought she would hurt her. Cradling her initially, she felt detached. “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 call her daughter the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like this facility is proving a simple point: when parents and infants remain united, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to collect her.
She departed the institution still in withdrawal, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still was concerned that authorities would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could walk in 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 didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Drugs came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for 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 the facility drove her to a clinic for methadone, provided orally. Gradually, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an specialist – 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 be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a mentor, visited with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a decoration on her head, resting on the floor with the exit nearby. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her leg for the other kids to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could be a mom.”
Tools for treating infants affected by substances have existed for decades.
The evaluation method was created in 1975|
