She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she had to return to get high again. She thought she still had several weeks to figure out how to get clean and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing a small weight – born before term, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been given shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she failed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her stop using only led to increased guilt and self-harm, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to tubes and leads, so little she thought she would hurt her. Holding her for the first time, she felt empty. “I just stared at 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 name her baby the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is identified with infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like this facility is proving a simple point: when mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She departed the institution still in withdrawal, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could enter and separate them.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. Drugs came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to let her down. She did not know how to value herself, much less anyone else.
Each day, staff from the center took her to a treatment center, provided orally. Slowly, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an specialist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. A support specialist, a mentor, stopped by with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is lean. Her face is downcast so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are gathered around, showing interest to the baby.
One child, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion looked at each other. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I would become a mother.”
Approaches for managing drug-exposed newborns have been available for years.
The evaluation method was created in 1975|