She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the hospital emergency room after her infection worsened up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
After five days, on a day in November 2022, Stephanie gave birth to a daughter weighing just over four pounds – early, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her final administration of fentanyl had been given shortly before she gave birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she failed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her supplier refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her quit only led to increased guilt and self-abuse, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt detached. “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 name her baby Izzie, after the professional who provided support 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 cared for jointly, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like this facility is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still worried that CPS would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could enter and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to love herself, not to mention anyone else.
Every day, staff from the facility took her to a treatment center, administered in pill form. Slowly, she was embracing sobriety.
She spent every minute 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 sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an professional – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. An advocate, a recovery coach, visited with her own five kids in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is wearing casual attire, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is lean. Her face is downcast so you do not see her expression. She is holding Izzie up on her lap for the young ones to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the dads were busy, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I would become a mother.”
Approaches for managing babies with exposure have been used for a long time.
The assessment tool was established in 1975|