A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby 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. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had taken the drug 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 figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
A short time later, on 12 November 2022, Stephanie had a daughter weighing just over four pounds – born before term, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered a few hours prior to birth.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she failed. She felt worthless, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her source refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her stop using only led to greater shame and negative self-talk, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to medical equipment, so tiny she thought she would harm her. Cradling her initially, she felt detached. “I gazed upon 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 the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when families are kept intact, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in detox, fearful and unsure about what would come next.
At the facility, Stephanie still feared that authorities would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could arrive and remove her child.
For the beginning period, Stephanie remained isolated. “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.”
Life on the streets, she said, was about enduring. Addiction came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to love herself, much less anyone else.
Each day, staff from the facility drove her to a treatment center, given as medication. Gradually, she was starting to get clean.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an professional – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own children in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, seated on the ground with the exit nearby. She is thin. Her face is downcast so you miss her features. She is holding Izzie up on her leg for the young ones to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could be a mom.”
Approaches for managing infants affected by substances have existed for decades.
The assessment tool was created in 1975|
