She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had built in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She slumped forward 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 sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had several weeks to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, 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 rehabilitation.
Five days later, on 12 November 2022, Stephanie delivered a daughter weighing a small weight – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her last dose of fentanyl had been given shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she relapsed. She felt without value, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her recover only led to greater shame and negative self-talk, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would break her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is proving a simple point: when families are kept intact, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, care providers came to bring her to the facility.
She departed the institution still in recovery, anxious and doubtful about what would happen next.
At the facility, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could walk in and take her baby away.
For the beginning period, 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 survival. Drugs came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to hurt her. She lacked the ability to love herself, not to mention anyone else.
Every day, staff from the center took her to a treatment center, administered in pill form. Over time, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating 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 born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the small baby 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 dark trousers and a sweatshirt, a beanie with a pompom on her head, seated on the ground with the exit nearby. She is slender. Her posture is humble so you miss her features. She is presenting her daughter on her knee for the other kids to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there given the chance.
“In the future,” 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 became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was established in 1975|