A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the ER after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had assembled in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she needed to go home to use once more. She thought she still had a month remaining to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but physicians found she also had an ruptured membrane. The nurse, Izzie, 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 abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
Five days later, on a day in November 2022, Stephanie gave birth to a daughter weighing a small weight – premature, little but surviving.
When the nurse asked 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 administered four hours before delivery.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she relapsed. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her quit only led to increased guilt and negative self-talk, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was attached to monitors, so small she thought she would break her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is identified with infant withdrawal condition regularly, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, results get better, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage 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 departed the institution still in recovery, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could arrive and take her baby away.
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. Substances came first; trust came last.
Stephanie had one close friend, 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, much less anyone else.
Every day, staff from the facility drove her to a clinic for methadone, administered in pill form. Slowly, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a peer support specialist, stopped by with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a cap with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her posture is humble so you miss her features. She is holding Izzie up on her leg for the children to see and they are standing close, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could be a mom.”
Methods to address infants affected by substances have been used for a long time.
The Finnegan NAS scale was developed in 1975|
