She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had built in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and vomited.
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 only a brief window to get treated before she had to return to use once more. She thought she still had several weeks to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten 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 rehabilitation.
Five days later, on a day in November 2022, Stephanie delivered a daughter weighing just over four pounds – early, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she relapsed. She felt worthless, blaming herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her stop using only led to increased guilt and self-abuse, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was attached to monitors, so little she thought she would break her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is found to have 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 Maddie’s Place is demonstrating a key fact: when families are kept intact, recovery succeeds, fewer children enter care 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, two staff members came to pick her up.
She left the medical center still in detox, fearful and unsure about what would happen next.
At the care center, Stephanie still feared that child services would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could arrive and remove her child.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to let her down. She was unable to value herself, not to mention anyone else.
Each day, staff from the facility took her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an specialist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her posture is humble so you do not see her expression. She is presenting her daughter on her knee for the children to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The parents responded that the men were occupied, 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 looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, 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|
