A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had sufficient opportunity 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 medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but physicians found she also had an ruptured membrane. 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 controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
After five days, on a day in November 2022, Stephanie gave birth to a baby girl weighing a small weight – premature, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided four hours before delivery.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she was unsuccessful. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her dealer would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her quit only led to deeper self-loathing and negative self-talk, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was attached to monitors, so small she thought she would hurt her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the professional who provided support to her.
Hospital staff told her about a care center, a unique recovery environment where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a small, growing network of centers like this facility is showing an important truth: when mothers and babies stay together, results get better, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She left the medical center still in recovery, fearful and unsure about what would follow.
At the facility, Stephanie still was concerned that authorities would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could walk in and separate them.
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 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 hurt her. She lacked the ability to care for herself, not to mention anyone else.
Daily, staff from the center took her to a treatment center, administered in pill form. Over time, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a recovery coach, visited with her own family in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” 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 bobble on her head, resting on the floor with the door behind her. She is lean. Her face is downcast so you miss her features. She is lifting the baby on her knee for the young ones to see and they are standing close, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, called away to other tasks, 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 Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.”
Tools for treating drug-exposed newborns have existed for decades.
The assessment tool was developed in 1975|