She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the hospital emergency room after her infection worsened up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and vomited.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to get high again. She thought she still had a month remaining to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – early, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her epidural had failed, her last dose of fentanyl had been provided four hours before delivery.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she relapsed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her love for her baby would make her quit only led to increased guilt and self-harm, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
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 harm her. Holding her for the first time, she felt empty. “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 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 new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in withdrawal, fearful and unsure about what would come next.
At the care center, Stephanie still was concerned that child services would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to love herself, much less anyone else.
Every day, staff from the center transported her to a recovery program, administered in pill form. Over time, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an professional – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a mentor, visited with her own children in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in casual attire, a cap with a pompom on her head, resting on the floor with the entryway at her back. She is slender. Her face is downcast so you do not see her expression. She is holding Izzie up on her leg for the young ones to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the men were occupied, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I would become a mother.”
Methods to address drug-exposed newborns have been available for years.
The Finnegan NAS scale was established in 1975|
