She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the medical facility after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. 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 get high.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie had a baby girl weighing just over four pounds – early, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her pain relief did not work, her final administration of fentanyl had been provided a few hours prior to birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she failed. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her source refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her recover only led to deeper self-loathing and self-abuse, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to tubes and leads, so small she thought she would break her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, results get better, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to collect her.
She left the medical center still in detox, scared and uncertain about what would happen next.
At the facility, Stephanie still was concerned that child services would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could walk in and take her baby away.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Addiction came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She was unable to love herself, much less anyone else.
Daily, staff from the center transported her to a treatment center, administered in pill form. Over time, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an professional – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in casual attire, a gray knit hat with a pompom on her head, resting on the floor with the door behind her. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the young ones to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the fathers had obligations, 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 the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could parent.”
Approaches for managing infants affected by substances have been used for a long time.
The Finnegan NAS scale was established in 1975|
