A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had constructed in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had a month remaining to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie gave birth to a infant weighing just over four pounds – premature, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she failed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her source refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her stop using only led to increased guilt 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 persistent condition.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to monitors, so tiny she thought she would break her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a innovative treatment home where women and their babies are treated together, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a developing system of centers like this facility is demonstrating a key fact: when parents and infants remain united, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, anxious and doubtful about what would come next.
At the facility, Stephanie still feared that child services would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could walk in and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “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.”
Homelessness, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to let her down. She was unable to care for herself, let alone anyone else.
Every day, staff from the center took her to a clinic for methadone, given as medication. Gradually, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a peer support specialist, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, resting on the floor with the entryway at her back. She is lean. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her lap for the children to see and they are standing close, showing interest to the baby.
A young boy, eight, asked the moms: “Why are there no men?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was developed in 1975|
