She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the hospital emergency room after her infection worsened up her legs. Without a job or home, estranged from her family, she resided in a small structure she had constructed in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she had to return to relapse. She thought she still had a month remaining to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her stop using only led to greater shame and negative self-talk, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to medical equipment, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a unique recovery environment where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to collect her.
She left the medical center still in detox, scared and uncertain about what would follow.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could walk in and separate them.
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 survival. Drugs came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to cause pain. She was unable to care for herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a treatment center, administered in pill form. Over time, she was embracing sobriety.
She spent every minute 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 obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an professional – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a decoration on her head, sitting on the wooden 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 gathered around, admiring and touching to the baby.
One child, eight, asked the parents: “What about the fathers?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I would become a mother.”
Approaches for managing babies with exposure have been used for a long time.
The Finnegan NAS scale was established in 1975|
