A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had built in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
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 use once more. She thought she still had four weeks left to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
Five days later, on 12 November 2022, Stephanie delivered a daughter weighing just over four pounds – premature, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, blaming herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her source refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her quit only led to greater shame and negative self-talk, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was hooked up to monitors, so little she thought she would hurt her. Embracing her at last, she felt empty. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when mothers and babies stay together, outcomes improve, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still feared that CPS would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could arrive and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Substances came first; trust 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 value herself, much less anyone else.
Each day, staff from Maddie’s Place drove her to a clinic for methadone, provided orally. Gradually, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is dressed in casual attire, a gray knit hat with a pompom on her head, seated on the ground with the door behind her. She is slender. Her face is downcast so you miss her features. She is presenting her daughter on her leg for the other kids to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the moms: “Why are there no men?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could be a mom.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
