She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she lived in a shed she had assembled in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and became sick.
Stephanie ultimately gave in. “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 use once more. She thought she still had four weeks left to find a way to become sober and deliver her child.
The medical professional intervened. 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 ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
A short time later, on a day in November 2022, Stephanie delivered a baby girl weighing a small weight – premature, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been administered shortly before she gave birth.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she failed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing 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 persistent condition.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was hooked up to tubes and leads, so little she thought she would harm her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter after her caregiver, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is found to have infant withdrawal condition frequently, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, care providers came to pick her up.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would come next.
At the facility, Stephanie still was concerned that authorities would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could walk in and separate them.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to hurt her. She was unable to care for herself, let alone anyone else.
Every day, staff from Maddie’s Place transported her to a recovery program, administered in pill form. Slowly, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an specialist – all frequent conditions for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They were innocent,” 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 clad in black pants and a hoodie, a cap with a bobble on her head, seated on the ground with the exit nearby. She is lean. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her lap for the young ones to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “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.”
Methods to address babies with exposure have been available for years.
The Finnegan NAS scale was developed in 1975|
