A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, Stephanie Rosell visited the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had built in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie gave birth to a daughter weighing a small weight – premature, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she failed. She felt without value, berating herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her quit only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so little she thought she would hurt her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition frequently, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is proving a simple point: when families are kept intact, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She left the medical center still in recovery, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still worried that authorities would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could arrive and take her baby away.
For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Addiction 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 was unable to value herself, much less anyone else.
Daily, staff from the center transported her to a clinic for methadone, provided orally. Over time, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration 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 dressed in casual attire, a cap with a pompom on her head, seated on the ground with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her knee for the young ones to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the moms: “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’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could parent.”
Tools for treating drug-exposed newborns have existed for decades.
The assessment tool was created in 1975|
