She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had just enough time to get treated before she had to return to use once more. She thought she still had four weeks left to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie delivered a baby girl weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her epidural had failed, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she was unsuccessful. She felt worthless, blaming herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her recover only led to deeper self-loathing and negative self-talk, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the NICU. When Stephanie at last met her, she was hooked up to medical equipment, so tiny she thought she would break her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms regularly, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a limited but expanding group of centers like the care home is showing an important truth: when mothers and babies stay together, results get better, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, care providers came to collect her.
She stepped out of the hospital still in detox, scared and uncertain about what would come next.
At the facility, Stephanie still feared that authorities would come take Izzie – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could enter and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Addiction came first; faith came last.
Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to cause pain. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, given as medication. Slowly, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. A support specialist, a recovery coach, came over with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you do not see her expression. She is holding Izzie up on her lap for the other kids to see and they are standing close, showing interest to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could be a mom.”
Approaches for managing babies with exposure have existed for decades.
The Finnegan NAS scale was established in 1975|
