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 lived in a shed she had built in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave 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 not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but doctors had discovered she also had an amniotic fluid leak. 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 at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
Five days later, on 12 November 2022, Stephanie had a daughter weighing 4lb 8oz – born before term, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided four hours before delivery.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she failed. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her affection for her child would make her recover only led to deeper self-loathing and negative self-talk, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a unique recovery environment where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a developing system of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to bring her to the facility.
She departed the institution still in recovery, scared and uncertain about what would come next.
At the facility, Stephanie still was concerned that CPS would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to let her down. She was unable to care for herself, much less anyone else.
Each day, staff from the facility drove her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She spent every minute 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 sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a mentor, came over with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her face is downcast so you do not see her expression. She is holding Izzie up on her knee for the young ones to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I was able. I could parent.”
Approaches for managing infants affected by substances have been available for years.
The evaluation method was established in 1975|
