She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the ER after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids 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 four weeks left to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses 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 often prescribed in substance abuse treatment.
Five days later, on the 12th of November, Stephanie delivered a daughter weighing a small weight – born before term, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her quit only led to greater shame and negative self-talk, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The infant was moved to the NICU. When Stephanie finally saw her her, she was attached to monitors, so little she thought she would break her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where women and their babies are treated together, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She left the medical center still in recovery, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still was concerned that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could walk in and take her baby away.
For the first two weeks, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to let her down. She did not know how to value herself, not to mention anyone else.
Daily, staff from the facility drove her to a recovery program, given as medication. Over time, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a peer support specialist, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is clad in casual attire, a cap with a bobble on her head, resting on the floor with the door behind her. She is slender. Her face is downcast so you cannot see her face. She is holding Izzie up on her knee for the children to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could parent.”
Methods to address drug-exposed newborns have been available for years.
The assessment tool was established in 1975|