A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had built in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she needed to go home to relapse. She thought she still had a month remaining to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
A short time later, on a day in November 2022, Stephanie delivered a baby girl weighing 4lb 8oz – born before term, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her epidural had failed, her final administration of fentanyl had been provided shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she relapsed. She felt worthless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her affection for her child would make her stop using only led to greater shame and negative self-talk, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so little she thought she would harm her. Embracing her at last, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms regularly, infants are still rushed to special care 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 mothers and babies stay together, results get better, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to pick her up.
She departed the institution still in detox, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still feared that authorities would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could enter and separate them.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to let her down. She was unable to value herself, much less anyone else.
Daily, staff from Maddie’s Place drove her to a recovery program, administered in pill form. Slowly, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own children in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in casual attire, a cap with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the children to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the moms: “Why are there no men?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”
Methods to address infants affected by substances have been used for a long time.
The assessment tool was created in 1975|
