She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and threw up.
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 sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had a month remaining to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities 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 commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie gave birth to a daughter weighing 4lb 8oz – early, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her last dose of fentanyl had been given a few hours prior to birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she failed. She felt worthless, blaming herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her source refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to deeper self-loathing and self-harm, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was hooked up to medical equipment, so tiny she thought she would harm her. Embracing her at last, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still feared that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could walk in and remove her child.
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.”
Life on the streets, she said, was about enduring. Drugs came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She was unable to care for herself, not to mention anyone else.
Each day, staff from the facility took her to a clinic for methadone, administered in pill form. Over time, she was embracing sobriety.
She utilized each moment beyond therapy 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 dietary support. She also had heightened sensory issues and required an professional – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a recovery coach, visited with her own five kids in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a bobble on her head, resting on the floor with the entryway at her back. She is slender. Her face is downcast so you cannot see her face. She is holding Izzie up on her leg for the children to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if possible.
“Once I become a parent,” 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 exchanged glances. “I became emotional,” 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 babies with exposure have been used for a long time.
The assessment tool was established in 1975|
