A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the ER after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had constructed in a acquaintance's garden. 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 eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had several weeks to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
A short time later, on 12 November 2022, Stephanie gave birth to a baby girl weighing a small weight – born before term, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her epidural had failed, her final administration of fentanyl had been provided shortly before she gave birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, blaming herself for not being able to overcome the challenge. An OBGYN told her to “only” stop using. Even her supplier refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her love for her baby would make her recover only led to greater shame and self-abuse, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The baby was taken to the NICU. When Stephanie at last met her, she was attached to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days 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 specialized facility, a new kind of care center where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when families are kept intact, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, two staff members came to collect her.
She left the medical center still in withdrawal, scared and uncertain about what would follow.
At the care center, Stephanie still feared that authorities would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie kept to herself. “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.”
Homelessness, she said, was about enduring. Drugs came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She lacked the ability to care for herself, let alone anyone else.
Daily, staff from the facility took her to a clinic for methadone, given as medication. Gradually, she was starting to get clean.
She spent every minute 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 adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had sensory challenges 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 was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a mentor, stopped by with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a cap with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith 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 would become a mother.”
Methods to address babies with exposure have existed for decades.
The Finnegan NAS scale was created in 1975|
