A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell went to the medical facility after her infection worsened up her legs. Without a job or home, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had taken the drug before coming to the ER 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 figure out how to get clean and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
Five days later, on 12 November 2022, Stephanie delivered a daughter weighing just over four pounds – born before term, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been given four hours before delivery.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she relapsed. She felt hopeless, berating herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her source declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her recover only led to increased guilt and self-harm, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie at last met her, she was connected to tubes and leads, so tiny she thought she would hurt her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt 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 a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like the care home is demonstrating a key fact: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She left the medical center still in withdrawal, fearful and unsure about what would happen next.
At the care center, Stephanie still was concerned that authorities would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could arrive and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to let her down. She did not know how to value herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a clinic for methadone, administered in pill form. Slowly, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an professional – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own children in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a cap with a decoration on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you cannot see her face. She is holding Izzie up on her knee for the other kids to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I could parent.”
Tools for treating drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
