She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, Stephanie Rosell went to the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had constructed in a acquaintance's garden. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she needed to go home to relapse. She thought she still had four weeks left to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – born before term, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been given four hours before delivery.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her supplier would not provide to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her recover only led to increased guilt and self-harm, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the NICU. When Stephanie at last met her, she was attached to tubes and leads, so little she thought she would harm her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What am I going to do with 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 a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms regularly, infants are still quickly moved to hospitals 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 families are kept intact, results get better, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to collect her.
She left the medical center still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any time, 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.”
Life on the streets, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She did not know how to value herself, not to mention anyone else.
Daily, staff from the center took her to a recovery program, given as medication. Over time, she was beginning recovery.
She spent every minute 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 intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for supervised visits with their babies. An advocate, a peer support specialist, stopped by with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is dressed in black pants and a hoodie, a beanie with a pompom on her head, sitting on the wooden floor with the door behind her. She is slender. Her posture is humble so you do not see her expression. She is holding Izzie up on her leg for the children to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The assessment tool was established in 1975|