She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she needed to go home to relapse. She thought she still had four weeks left to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – born before term, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been provided a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she failed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her source refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her quit only led to increased guilt and self-abuse, a cause for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, so little she thought she would harm 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 continued to doubt she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a developing system of centers like this facility is showing an important truth: when families are kept intact, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. 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 withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that CPS would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could enter and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to cause pain. She lacked the ability to care for herself, much less anyone else.
Each day, staff from the center took her to a recovery program, given as medication. Gradually, she was beginning recovery.
She spent every minute 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 feeding therapy. She also had increased sensitivity and required an specialist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. An advocate, a mentor, came over with her own children in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her face is downcast so you do not see her expression. She is lifting the baby on her knee for the children to see and they are standing close, showing interest to the baby.
A young boy, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could parent.”
Approaches for managing infants affected by substances have been used for a long time.
The evaluation method was developed in 1975|
