A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after a serious infection started to spread 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 medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she had to return to use once more. She thought she still had four weeks left to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
After five days, on a day in November 2022, Stephanie gave birth to a daughter weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her stop using only led to increased guilt and self-abuse, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a unique recovery environment where women and their babies are treated together, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like the care home is proving a simple point: when parents and infants remain united, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to collect her.
She left the medical center still in withdrawal, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still worried that authorities would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could enter and take her baby away.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to cause pain. She did not know how to love herself, not to mention anyone else.
Every day, staff from the center drove her to a treatment center, given as medication. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – 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.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. An advocate, a recovery coach, visited with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the entryway at her back. She is thin. Her face is downcast so you cannot see her face. She is lifting the baby on her lap for the other kids to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I would become a mother.”
Tools for treating drug-exposed newborns have been available for years.
The assessment tool was developed in 1975|
