She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell visited the ER after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had built 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 slumped forward and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had just enough time 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 give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
After five days, on a day in November 2022, Stephanie delivered a infant weighing a small weight – born before term, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she failed. She felt without value, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her source declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-harm, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the NICU. When Stephanie finally saw her her, she was connected to monitors, so small she thought she would harm her. Holding her for the first time, she felt empty. “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.
Following a brief period she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a innovative treatment home where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is demonstrating a key fact: when families are kept intact, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She stepped out of the hospital still in recovery, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still was concerned that CPS would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could arrive and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to cause pain. She was unable to value herself, much less anyone else.
Every day, staff from the facility drove her to a clinic for methadone, administered in pill form. Over time, 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 sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. An advocate, a recovery coach, 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 children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is wearing casual attire, a cap with a pompom on her head, resting on the floor with the exit nearby. She is lean. Her posture is humble so you miss her features. She is lifting the baby on her leg for the young ones to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could parent.”
Tools for treating infants affected by substances have been used for a long time.
The evaluation method was established in 1975|
