A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell visited the medical facility after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had built in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had several weeks to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie had a infant weighing a small weight – premature, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her last dose of fentanyl had been given shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she failed. She felt hopeless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her supplier would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her quit only led to deeper self-loathing and negative self-talk, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The newborn was transferred to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to monitors, so little she thought she would hurt her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby 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 identified with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, care providers came to pick her up.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that authorities would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and remove her child.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Addiction came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to love herself, let alone anyone else.
Every day, staff from Maddie’s Place transported her to a treatment center, provided orally. Gradually, she was starting to get clean.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all typical problems for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration 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. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a beanie with a bobble on her head, seated on the ground with the exit nearby. She is thin. Her head is tilted forward so you miss her features. She is holding Izzie up on her knee for the other kids to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the parents: “Why are there no men?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I could be a mom.”
Methods to address babies with exposure have been available for years.
The Finnegan NAS scale was created in 1975|
