She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the ER after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. 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 eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she needed to go home to use once more. She thought she still had four weeks left to find a way to become sober and have this baby.
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 severe, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
After five days, on 12 November 2022, Stephanie delivered a infant weighing 4lb 8oz – premature, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been administered four hours before delivery.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she failed. She felt hopeless, blaming herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her source would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her stop using only led to deeper self-loathing and negative self-talk, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the NICU. When Stephanie at last met her, she was hooked up to medical equipment, so little she thought she would hurt her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, care providers came to pick her up.
She left the medical center still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that authorities would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any point, someone could walk in and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She did not know how to value herself, not to mention anyone else.
Every day, staff from the center transported her to a recovery program, provided orally. Over time, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an specialist – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a mentor, visited with her own children in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She has an image of the moment. She is wearing black pants and a hoodie, a beanie with a decoration on her head, seated on the ground with the exit nearby. She is thin. Her posture is humble so you cannot see her face. She is presenting her daughter on her lap for the children to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the moms: “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.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I would become a mother.”
Approaches for managing infants affected by substances have existed for decades.
The assessment tool was created in 1975|
