A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the hospital emergency room after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she was compelled to leave to get high again. She thought she still had a month remaining to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, 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 abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a daughter weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she failed. She felt worthless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her dealer refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her quit only led to increased guilt and self-abuse, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was connected to medical equipment, so tiny she thought she would harm her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is found to have infant withdrawal condition frequently, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a small, growing network of centers like this facility is demonstrating a key fact: when families are kept intact, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, two staff members came to pick her up.
She left the medical center still in recovery, scared and uncertain about what would happen next.
At the facility, Stephanie still was concerned that child services would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in 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.”
Life on the streets, she said, was about enduring. Substances came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She did not know how to value herself, not to mention anyone else.
Daily, staff from Maddie’s Place took her to a recovery program, provided orally. Over time, she was starting to get clean.
She utilized each moment outside treatment 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 obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, 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 guided meetings with their babies. Katie Bunch-Smith, a mentor, visited with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is dressed in black pants and a hoodie, a beanie with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her leg for the other kids to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address infants affected by substances have existed for decades.
The Finnegan NAS scale was developed in 1975|