She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, 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 companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. 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 used fentanyl before seeking medical help and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had a month remaining to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
After five days, on 12 November 2022, Stephanie had a baby girl weighing a small weight – born before term, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she failed. She felt worthless, criticizing herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her source would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her stop using only led to deeper self-loathing and self-abuse, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was attached to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a unique recovery environment 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 neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in recovery, fearful and unsure about what would come next.
At the care center, Stephanie still feared that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could arrive and separate them.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Drugs came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to cause pain. She was unable to care for herself, not to mention anyone else.
Each day, staff from the center drove her to a treatment center, provided orally. Slowly, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support 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 increased sensitivity and required an occupational therapist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, visited with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is clad in black pants and a hoodie, a gray knit hat with a pompom on her head, sitting on the wooden floor with the exit nearby. She is thin. Her posture is humble so you do not see her expression. She is holding Izzie up on her knee for the children to see and they are gathered around, showing interest to the baby.
One child, eight, asked the parents: “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.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could parent.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was developed in 1975|
