A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the ER after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had built in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she needed to go home to get high again. She thought she still had four weeks left to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
A short time later, on a day in November 2022, Stephanie gave birth to a daughter weighing just over four pounds – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her recover only led to increased guilt and self-harm, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The baby was taken to the NICU. When Stephanie eventually visited her, she was attached to tubes and leads, so small she thought she would hurt her. Embracing her at last, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to pick her up.
She stepped out of the hospital still in detox, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still feared that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could enter and take her baby away.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to cause pain. She did not know how to love herself, let alone anyone else.
Daily, staff from the center took her to a clinic for methadone, administered in pill form. Over time, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care 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 professional – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
During a pre-holiday visit, 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 drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is dressed in casual attire, a gray knit hat with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her head is tilted forward so you do not see her expression. She is lifting the baby on her knee for the other kids to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I would become a mother.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
