She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell went to the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she lived in a shed she had built in a companion's property. 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 threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before seeking medical help and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had several weeks to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
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 drug that alleviates cravings and is often prescribed in addiction recovery.
A short time later, on a day in November 2022, Stephanie delivered a infant weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been administered a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt worthless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her dealer refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her love for her baby would make her quit only led to greater shame and self-abuse, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the NICU. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would break her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Hospital staff 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 much of the US, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. 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 future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to pick her up.
She departed the institution still in withdrawal, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still was concerned that authorities would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any time, someone could arrive and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She did not know how to value herself, not to mention anyone else.
Each day, staff from the facility transported her to a recovery program, given as medication. Slowly, she was embracing sobriety.
She spent every minute 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 feeding therapy. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a recovery coach, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a bobble on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you miss her features. She is lifting the baby on her knee for the other kids to see and they are gathered around, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I could parent.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was developed in 1975|
