She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she needed to go home 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 staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.
Five days later, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – premature, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt worthless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her stop using only led to greater shame and self-harm, a cause for her to relapse. Yet she could not easily command 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 attached to tubes and leads, so little she thought she would hurt 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.
Two days later she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a new kind of care center where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a small, growing network of centers like the care home is proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and future expenses reduce.
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 bring her to the facility.
She departed the institution still in recovery, fearful and unsure about what would come next.
At the care center, Stephanie still worried that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; reliance 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, let alone anyone else.
Daily, staff from Maddie’s Place transported her to a treatment center, given as medication. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges 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 exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, stopped by with her own children in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is slender. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her lap for the children to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith exchanged glances. “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 Finnegan NAS scale was created in 1975|
