She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell visited the ER after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had assembled in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she needed to go home to get high again. She thought she still had a month remaining to find a way to become sober and have this baby.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she failed. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “just” 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 stop using only led to greater shame and negative self-talk, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the NICU. When Stephanie at last met her, she was hooked up to medical equipment, so tiny she thought she would hurt her. Cradling her initially, she felt nothing. “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 after her caregiver, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is identified with infant withdrawal condition frequently, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, recovery succeeds, foster placements fall and future expenses reduce.
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, two staff members came to pick her up.
She left the medical center still in recovery, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still was concerned that CPS would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie kept to herself. “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.”
Survival outdoors, she said, was about enduring. Substances came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to let her down. She did not know how to love herself, not to mention anyone else.
Daily, staff from Maddie’s Place drove her to a clinic for methadone, given as medication. Gradually, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an specialist – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in casual attire, a cap with a bobble on her head, resting on the floor with the entryway at her back. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her lap for the other kids to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “What about the fathers?” The parents responded that the dads were busy, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I could be a mom.”
Tools for treating drug-exposed newborns have been available for years.
The Finnegan NAS scale was created in 1975|
