She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the medical facility after an infection began spreading 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 physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had only a brief window 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 medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery 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 infant weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been provided shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her dealer refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her love for her baby would make her recover only led to greater shame and negative self-talk, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the special care nursery. When Stephanie at last met her, she was hooked up to monitors, so tiny 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 remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to pick her up.
She departed the institution still in detox, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still feared that CPS would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any moment, someone could walk in and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She lacked the ability to value herself, much less anyone else.
Daily, staff from Maddie’s Place drove her to a treatment center, administered in pill form. Slowly, she was beginning recovery.
She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a peer support specialist, came over with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in casual attire, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I could parent.”
Methods to address babies with exposure have been available for years.
The assessment tool was established in 1975|
