She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the medical facility after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had assembled 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 threw up.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had four weeks left to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but doctors had discovered 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.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
After five days, on a day in November 2022, Stephanie delivered a baby girl weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she was unsuccessful. She felt without value, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her stop using only led to deeper self-loathing and self-harm, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was hooked up to tubes and leads, so tiny she thought she would break her. Holding her for the first time, 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 name her baby Izzie, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is showing an important truth: when parents and infants remain united, outcomes improve, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.
At the care center, Stephanie still was concerned that child services would come seize her child – 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 stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. 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 cause pain. She lacked the ability to value herself, let alone anyone else.
Every day, staff from the facility took her to a clinic for methadone, provided orally. Slowly, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. A support specialist, a peer support specialist, stopped by with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a cap with a pompom on her head, resting on the floor with the entryway at her back. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her lap for the other kids to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I would become a mother.”
Tools for treating infants affected by substances have existed for decades.
The Finnegan NAS scale was established in 1975|
