She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had constructed in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to find a way to become sober and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.
A short time later, on 12 November 2022, Stephanie gave birth to a baby girl weighing a small weight – born before term, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her epidural had failed, her final administration of fentanyl had been provided four hours before delivery.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt without value, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her affection for her child would make her quit only led to deeper self-loathing and self-abuse, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was connected to medical equipment, so tiny she thought she would hurt her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the professional who provided support to her.
Medical personnel told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like the care home is demonstrating a key fact: when parents and infants remain united, results get better, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to pick her up.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the facility, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in 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 was suspicious at that point.”
Survival outdoors, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She was unable to love herself, let alone anyone else.
Each day, staff from Maddie’s Place drove her to a treatment center, provided orally. Slowly, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an professional – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, visited with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a beanie with a decoration on her head, sitting on the wooden floor with the door behind her. She is slender. Her posture is humble so you cannot see her face. She is lifting the baby on her lap for the other kids to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I could be a mom.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was developed in 1975|