A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to 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 constructed in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had just enough time to get treated before she needed to go home to use once more. She thought she still had four weeks left to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but doctors had discovered she also had an amniotic fluid leak. 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 controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie delivered a infant weighing a small weight – premature, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she relapsed. She felt hopeless, berating herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her dealer refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her recover only led to deeper self-loathing 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 chronic disease.
The infant was moved to the NICU. When Stephanie eventually visited her, she was attached to monitors, so small she thought she would harm her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Hospital staff 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 many parts of America, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is proving a simple point: when families are kept intact, results get better, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to pick her up.
She departed the institution still in recovery, anxious and doubtful about what would follow.
At the facility, Stephanie still worried that child services would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Addiction came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to let her down. She was unable to care for herself, let alone anyone else.
Daily, staff from the center took her to a treatment center, administered in pill form. Over time, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own five kids in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is dressed in casual attire, a gray knit hat with a bobble on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you cannot see her face. She is holding Izzie up on her leg for the children to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the men were occupied, 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 the specialist made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I found the courage. I would become a mother.”
Tools for treating infants affected by substances have been available for years.
The assessment tool was established in 1975|
