She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and use drugs.”
She had taken the drug before seeking medical help 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 deliver her child.
The nurse had other ideas. 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 serious, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – born before term, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she was unsuccessful. She felt without value, blaming herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her recover only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to tubes and leads, so little she thought she would hurt her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a care center, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to pick her up.
She left the medical center still in detox, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still feared that child services 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 take her baby away.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to cause pain. She lacked the ability to love herself, much less anyone else.
Each day, staff from the center took her to a recovery program, given as medication. Gradually, she was starting to get clean.
She utilized each moment beyond therapy 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 occupational therapist – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. An advocate, a recovery coach, visited with her own family in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a pompom on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you do not see her expression. She is holding Izzie up on her knee for the young ones to see and they are standing close, showing interest to the baby.
One child, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there if they could.
“When I have kids,” 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 just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could parent.”
Approaches for managing babies with exposure have been used for a long time.
The evaluation method was created in 1975|
