A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had constructed in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had just enough time to get treated before she needed to go home to get high again. She thought she still had several weeks to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie had a infant weighing just over four pounds – premature, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been provided four hours before delivery.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she was unsuccessful. She felt worthless, berating herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her stop using only led to deeper self-loathing and self-harm, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I just stared 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 name her baby after her caregiver, after the professional who provided support to her.
Hospital staff told her about a care center, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition regularly, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like the care home is showing an important truth: when mothers and babies stay together, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in recovery, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still was concerned that child services would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could walk in and separate them.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to hurt her. She was unable to care for herself, not to mention anyone else.
Every day, staff from Maddie’s Place transported her to a treatment center, provided orally. Over time, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an occupational therapist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, stopped by with her own children in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed 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. They focused only on the baby.”
She holds a picture of the moment. She is wearing casual attire, a cap with a pompom on her head, resting on the floor with the entryway at her back. She is slender. Her posture is humble so you do not see her expression. She is presenting her daughter on her lap for the young ones to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the parents: “What about the fathers?” The moms tried to explain that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could parent.”
Tools for treating infants affected by substances have been used for a long time.
The Finnegan NAS scale was developed in 1975|