A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she needed to go home to get high again. She thought she still had a month remaining to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
After five days, on a day in November 2022, Stephanie gave birth to a infant weighing just over four pounds – born before term, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was numb. Her pain relief did not work, her last dose of fentanyl had been given shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she was unsuccessful. She felt worthless, criticizing herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“However, I failed,” 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 negative self-talk, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was hooked up to monitors, so little she thought she would hurt her. Embracing her at last, she felt empty. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is identified with newborn addiction symptoms frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is proving a simple point: when parents and infants remain united, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to pick her up.
She departed the institution still in recovery, anxious and doubtful about what would follow.
At the facility, Stephanie still worried that authorities would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could arrive and take her baby away.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to let her down. She did not know how to care for herself, let alone anyone else.
Daily, staff from Maddie’s Place drove her to a clinic for methadone, administered in pill form. Gradually, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a peer support specialist, stopped by with her own children in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in casual attire, a beanie with a bobble on her head, seated on the ground with the exit nearby. She is lean. Her face is downcast so you cannot see her face. She is holding Izzie up on her leg for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “Why are there no men?” The parents responded that the dads were busy, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
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 be a mom.”
Approaches for managing babies with exposure have been available for years.
The evaluation method was developed in 1975|
