She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the ER after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, 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. The onset of withdrawal began. She leaned over the bed and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she had to return to use once more. She thought she still had a month remaining to find a way to become sober and have this baby.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but physicians found she also had an ruptured membrane. 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 withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
Five days later, on 12 November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – early, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her epidural had failed, her previous intake of fentanyl had been provided four hours before delivery.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she failed. She felt worthless, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her stop using only led to deeper self-loathing and negative self-talk, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the NICU. When Stephanie at last met her, she was connected to medical equipment, so tiny she thought she would break her. Cradling her initially, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period 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 Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when mothers and babies stay together, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She departed the institution still in recovery, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still was concerned that CPS would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could walk in and separate them.
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.”
Homelessness, she said, was about getting by. Substances came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She was unable to care for herself, much less anyone else.
Each day, staff from Maddie’s Place took her to a treatment center, given as medication. Slowly, she was beginning recovery.
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 intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an specialist – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, sitting on the wooden floor with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the young ones to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could parent.”
Tools for treating drug-exposed newborns have existed for decades.
The assessment tool was established in 1975|
