A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the hospital emergency room after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She slumped forward and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had only a brief window to get treated before she needed to go home to get high again. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The medical professional intervened. 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 severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
She encouraged 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 drug that alleviates cravings and is often prescribed in rehabilitation.
Five days later, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – early, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she failed. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her stop using only led to greater shame and self-abuse, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to medical equipment, so small she thought she would harm her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to give her child the name Izzie, after the nurse who had been so kind 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 numerous states, where a baby is identified with 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 mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, care providers came to pick her up.
She stepped out of the hospital still in recovery, anxious and doubtful about what would happen next.
At the facility, Stephanie still feared that child services would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could walk in and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Substances came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to hurt her. She was unable to value herself, let alone anyone else.
Each day, staff from the center took her to a treatment center, provided orally. Over time, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own children in tow to drop off cookies. They all assembled beside 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. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in casual attire, a cap with a bobble on her head, resting on the floor with the exit nearby. She is thin. Her posture is humble so you cannot see her face. She is holding Izzie up on her lap for the other kids to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I would become a mother.”
Methods to address infants affected by substances have been available for years.
The Finnegan NAS scale was established in 1975|
