A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, Stephanie Rosell arrived at the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had built in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had taken the drug before coming to the ER and had just enough time to get treated before she had to return to get high again. She thought she still had four weeks left to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection 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.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie delivered a daughter weighing 4lb 8oz – born before term, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been provided a few hours prior to birth.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she was unsuccessful. She felt hopeless, berating herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her supplier refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her affection for her child would make her recover only led to greater shame and self-abuse, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to tubes and leads, so small she thought she would harm her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength 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 detox, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still was concerned that authorities would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could walk in and separate them.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about enduring. Substances 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 lacked the ability to value herself, not to mention anyone else.
Every day, staff from Maddie’s Place drove her to a treatment center, given as medication. Slowly, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an specialist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. An advocate, a mentor, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is clad in casual attire, a beanie with a bobble on her head, resting on the floor with the exit nearby. She is thin. Her head is tilted forward so you miss her features. She is presenting her daughter on her leg for the children to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The parents responded that the men were occupied, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I would become a mother.”
Methods to address babies with exposure have been available for years.
The assessment tool was established in 1975|
