A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell visited the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she needed to go home to relapse. 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.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, 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 often prescribed in rehabilitation.
A short time later, on the 12th of November, Stephanie gave birth to a baby girl weighing 4lb 8oz – early, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been provided four hours before delivery.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her supplier would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her stop using only led to deeper self-loathing and self-abuse, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was connected to tubes and leads, so small she thought she would hurt her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a innovative treatment home where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to collect her.
She stepped out of the hospital still in detox, anxious and doubtful about what would follow.
At the facility, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could enter and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She was unable to care for herself, not to mention anyone else.
Each day, staff from the center drove her to a recovery program, given as medication. Slowly, she was starting to get clean.
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 sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. A support specialist, a mentor, visited with her own family in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a cap with a bobble on her head, seated on the ground with the door behind her. She is lean. Her face is downcast so you do not see her expression. She is lifting the baby on her leg for the children to see and they are gathered around, 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 possible.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
