She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell arrived at the ER after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before seeking medical help and had only a brief window 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 deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
A short time later, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – born before term, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she relapsed. She felt hopeless, berating herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her quit only led to greater shame and self-harm, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
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. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter 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 parents and infants affected by substance use are supported as a unit, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when mothers and babies stay together, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to pick her up.
She left the medical center still in detox, anxious and doubtful about what would happen next.
At the care center, Stephanie still feared that child services would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to let her down. She lacked the ability to care for herself, much less anyone else.
Every day, staff from the center took her to a recovery program, administered in pill form. 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 getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a recovery coach, came over with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, seated on the ground with the entryway at her back. She is thin. Her face is downcast so you do not see her expression. She is lifting the baby on her lap for the other kids to see and they are gathered around, showing interest to the baby.
One child, eight, asked the moms: “Why are there no men?” The parents responded that the dads were busy, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could parent.”
Methods to address infants affected by substances have been available for years.
The evaluation method was developed in 1975|
