A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she lived in a shed she had built in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
After five days, on 12 November 2022, Stephanie had a infant weighing 4lb 8oz – early, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her epidural had failed, her final administration of fentanyl had been provided four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she was unsuccessful. She felt worthless, blaming herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her source would not provide 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 quit only led to greater shame 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 long-term illness.
The infant was moved to the NICU. When Stephanie at last met her, she was connected to tubes and leads, so small she thought she would break her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the professional who provided support to her.
Hospital staff told her about a care center, a new kind of care center where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition regularly, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is showing an important truth: when parents and infants remain united, results get better, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She left the medical center still in recovery, scared and uncertain about what would come next.
At the care center, Stephanie still worried that child services would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could enter and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “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.”
Homelessness, she said, was about survival. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She lacked the ability to value herself, not to mention anyone else.
Daily, staff from the facility transported her to a treatment center, given as medication. Over time, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
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 peer support specialist, came over with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a cap with a decoration on her head, seated on the ground with the door behind her. She is slender. Her face is downcast so you cannot see her face. She is lifting the baby on her leg for the young ones to see and they are gathered around, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”
Tools for treating infants affected by substances have existed for decades.
The Finnegan NAS scale was created in 1975|
