A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the ER after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had built in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had several weeks to plan her recovery and give birth.
The attending nurse disagreed. 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 serious, 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 controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
Five days later, on the 12th of November, Stephanie gave birth to a infant weighing just over four pounds – premature, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she was unsuccessful. She felt hopeless, berating herself for not being able to do the impossible. An doctor told her to “simply” 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 widespread belief that her bond with her newborn would make her recover only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the NICU. When Stephanie at last met her, she was attached to medical equipment, so little she thought she would break her. Embracing her at last, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, recovery succeeds, 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, two staff members came to bring her to the facility.
She departed the institution still in withdrawal, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still feared that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could arrive and take her baby away.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Each day, staff from Maddie’s Place drove her to a recovery program, given as medication. Over time, she was starting to get clean.
She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an specialist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own children in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the children to see and they are standing close, showing interest to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could parent.”
Approaches for managing infants affected by substances have been available for years.
The assessment tool was created in 1975|
