She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the ER after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she was compelled to leave to get high again. She thought she still had several weeks to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
Five days later, on 12 November 2022, Stephanie gave birth to a daughter weighing a small weight – premature, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her epidural had failed, her last dose of fentanyl had been given shortly before she gave birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she failed. She felt hopeless, blaming herself for not being able to overcome the challenge. An obstetrician 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 had to seek support.”
The widespread belief that her bond with her newborn would make her quit only led to increased guilt and self-abuse, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so tiny she thought she would harm her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to pick her up.
She departed the institution still in recovery, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that authorities would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could walk in and separate them.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Substances came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to cause pain. She did not know how to love herself, much less anyone else.
Every day, staff from the facility took her to a recovery program, given as medication. Slowly, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an professional – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the tiny infant 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 holds a picture of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is slender. Her head is tilted forward so you cannot see her face. She is lifting the baby on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was established in 1975|
