She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after an infection began spreading up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she needed to go home to get high again. She thought she still had four weeks left to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm 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 substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a daughter weighing a small weight – born before term, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was numb. Her epidural had failed, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she was unsuccessful. She felt worthless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her quit only led to increased guilt and negative self-talk, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The newborn was transferred to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to tubes and leads, so little she thought she would break her. Cradling her initially, she felt empty. “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.
Hospital staff told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms frequently, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, care providers came to bring her to the facility.
She left the medical center still in detox, fearful and unsure about what would come next.
At the facility, Stephanie still feared that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could arrive and remove her child.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to value herself, let alone anyone else.
Every day, staff from the center transported her to a clinic for methadone, provided orally. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. A support specialist, a mentor, visited with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is dressed in black pants and a hoodie, a beanie with a bobble on her head, resting on the floor with the door behind her. She is lean. Her posture is humble so you do not see her expression. She is holding Izzie up on her lap for the young ones to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The parents responded that the men were occupied, handling responsibilities, that they would be there if they could.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The evaluation method was developed in 1975|
