She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell went to the medical facility after her infection worsened up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she had to return to relapse. She thought she still had several weeks to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
A short time later, on a day in November 2022, Stephanie gave birth to a baby girl weighing just over four pounds – premature, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her epidural had failed, her final administration of fentanyl had been provided a few hours prior to birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her recover only led to increased guilt and self-abuse, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so little she thought she would hurt her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, results get better, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, care providers came to bring her to the facility.
She departed the institution still in recovery, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still worried that authorities would come take Izzie – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could enter and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Substances came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to let her down. She was unable to care for herself, let alone anyone else.
Daily, staff from Maddie’s Place transported her to a clinic for methadone, given as medication. Slowly, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an professional – 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 could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed 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 slender. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her knee for the other kids to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could be a mom.”
Tools for treating infants affected by substances have been available for years.
The Finnegan NAS scale was created in 1975|