A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell visited the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had several weeks to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie gave birth to a baby girl weighing just over four pounds – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided a few hours prior to birth.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she was unsuccessful. She felt hopeless, berating herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her source refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her affection for her child would make her quit only led to greater shame and negative self-talk, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was attached to monitors, so small she thought she would break her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period 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 innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is found to have infant withdrawal condition frequently, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is showing an important truth: when families are kept intact, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, care providers came to bring her to the facility.
She left the medical center still in recovery, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any time, someone could walk in and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to care for herself, let alone anyone else.
Each day, staff from the center drove her to a treatment center, provided orally. Gradually, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, seated on the ground 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 leg for the other kids to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the moms: “What about the fathers?” The parents responded that the dads were busy, handling responsibilities, that they would be there if they could.
“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 just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I would become a mother.”
Methods to address infants affected by substances have been used for a long time.
The Finnegan NAS scale was created in 1975|
