A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, Stephanie Rosell visited the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She slumped forward and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
Izzie persuaded 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 switched to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
Five days later, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she failed. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her quit 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 will away a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt detached. “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 call her daughter the same as her nurse, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where women and their babies are treated together, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a small, growing network of centers like this facility is proving a simple point: when families are kept intact, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to bring her to the facility.
She left the medical center still in detox, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still feared that child services would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could walk in and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Drugs came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She did not know how to value herself, much less anyone else.
Every day, staff from Maddie’s Place took her to a treatment center, administered in pill form. Gradually, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention 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 sensory challenges and required an specialist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. A support specialist, a recovery coach, visited with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in casual attire, a gray knit hat with a decoration on her head, sitting on the wooden floor with the exit nearby. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her leg for the other kids to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “When a child recognized 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 assessment tool was created in 1975|
