A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the ER 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 constructed in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. 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 needed to go home to use once more. She thought she still had a month remaining to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was critical, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
After five days, on a day in November 2022, Stephanie delivered a infant weighing 4lb 8oz – early, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been provided a few hours prior to birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she relapsed. She felt worthless, criticizing herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her stop using only led to deeper self-loathing and negative self-talk, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was attached to medical equipment, so small she thought she would break her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the professional who provided support to her.
Medical personnel 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 found to have newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, care providers came to collect her.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and separate them.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Drugs came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Daily, staff from the center transported her to a treatment center, provided orally. Over time, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, resting on the floor with the door behind her. She is thin. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her knee for the young ones to see and they are standing close, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“When I have kids,” 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 could do this. I could parent.”
Tools for treating drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
