A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had several weeks to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a infant weighing 4lb 8oz – born before term, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided a few hours prior to birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her quit only led to deeper self-loathing and self-abuse, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the NICU. When Stephanie at last met her, she was attached to medical equipment, so little she thought she would break her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure 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 care center, a innovative treatment home where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any time, someone could arrive and remove her child.
For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Drugs came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to hurt her. She did not know how to care for herself, not to mention anyone else.
Every day, staff from Maddie’s Place took her to a recovery program, given as medication. Slowly, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an professional – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in casual attire, a cap with a bobble on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are standing close, showing interest to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could be a mom.”
Approaches for managing babies with exposure have existed for decades.
The assessment tool was created in 1975|
