A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, 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. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – early, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her epidural had failed, her last dose of fentanyl had been given four hours before delivery.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her recover only led to increased guilt and self-harm, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to monitors, so small she thought she would hurt 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 call her daughter Izzie, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use 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 treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility 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 happen next.
At Maddie’s Place, Stephanie still feared that CPS would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could walk in 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. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to hurt her. She was unable to care for herself, let alone anyone else.
Daily, staff from the center transported her to a clinic for methadone, given as medication. Slowly, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an specialist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own children in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration 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 dressed in black pants and a hoodie, a cap with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her posture is humble so you cannot see her face. She is holding Izzie up on her lap for the other kids to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the moms: “Where are all the dads?” The parents responded that the men were occupied, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I would become a mother.”
Tools for treating babies with exposure have been available for years.
The Finnegan NAS scale was established in 1975|
