She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had several weeks to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
After five days, on 12 November 2022, Stephanie had a infant weighing just over four pounds – premature, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her pain relief did not work, her last dose of fentanyl had been administered four hours before delivery.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The common assumption that her love for her baby would make her recover only led to greater shame and self-harm, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to give her child the name the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is showing an important truth: when families are kept intact, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would happen next.
At the care center, Stephanie still was concerned that authorities would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could arrive and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Every day, staff from the facility took her to a recovery program, given as medication. Gradually, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an professional – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, stopped by with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in casual attire, a cap with a bobble on her head, seated on the ground with the entryway at her back. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her lap for the young ones to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the dads were busy, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I could parent.”
Approaches for managing infants affected by substances have been available for years.
The assessment tool was created in 1975|
