A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, Stephanie Rosell went to the ER after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she needed to go home to relapse. She thought she still had a month remaining to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
After five days, on the 12th of November, Stephanie gave birth to a baby girl weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she failed. She felt hopeless, blaming herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her stop using only led to greater shame and self-harm, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was attached to medical equipment, so little she thought she would harm her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a small, growing network of centers like this facility is proving a simple point: when mothers and babies stay together, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to collect her.
She stepped out of the hospital still in recovery, scared and uncertain about what would happen next.
At the care center, Stephanie still worried that authorities would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and remove her child.
For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, 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 cause pain. She lacked the ability to care for herself, not to mention anyone else.
Every day, staff from the facility took her to a treatment center, given as medication. Gradually, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an professional – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, came over with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is wearing black pants and a hoodie, a beanie with a bobble on her head, resting on the floor with the door behind her. She is thin. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I found the courage. I could parent.”
Approaches for managing infants affected by substances have existed for decades.
The assessment tool was created in 1975|
