A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, 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 addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she had to return to relapse. She thought she still had four weeks left to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, 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. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
A short time later, on the 12th of November, Stephanie had a infant weighing 4lb 8oz – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been provided shortly before she gave birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, berating herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was attached to monitors, so little she thought she would break her. Embracing her at last, she felt detached. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She left the medical center still in recovery, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still feared that CPS would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could arrive and remove her child.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about enduring. Substances came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She did not know how to love herself, much less anyone else.
Every day, staff from the facility took her to a treatment center, administered in pill form. Over time, she was starting to get clean.
She utilized each moment when not in sessions 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 severe digestive problems. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. 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. Katie Bunch-Smith, a peer support specialist, visited with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She has an image of the moment. She is dressed in casual attire, a beanie with a bobble on her head, resting on the floor with the exit nearby. She is slender. Her posture is humble so you miss her features. She is presenting her daughter on her knee for the young ones to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the mothers: “Why are there no men?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”
Methods to address infants affected by substances have been used for a long time.
The evaluation method was established in 1975|
