She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the ER after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she needed to go home to use once more. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses 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 addiction recovery.
Five days later, on 12 November 2022, Stephanie delivered a baby girl weighing a small weight – premature, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been administered four hours before delivery.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she failed. She felt worthless, berating herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her source refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to increased guilt and self-harm, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to monitors, so small she thought she would hurt her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition regularly, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like this facility is proving a simple point: when mothers and babies stay together, outcomes improve, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would come next.
At the facility, 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 remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Addiction came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to cause pain. She was unable to care for herself, let alone anyone else.
Each day, staff from the facility transported her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care 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 sensory challenges and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. An advocate, a peer support specialist, stopped by with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is wearing black pants and a hoodie, a gray knit hat with a bobble on her head, sitting on the wooden floor with the exit nearby. She is slender. Her face is downcast so you miss her features. She is presenting her daughter on her leg for the children to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the dads were busy, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could parent.”
Tools for treating drug-exposed newborns have been available for years.
The assessment tool was established in 1975|
