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 her infection worsened up her legs. Without a job or home, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also addicted to fentanyl.

As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and vomited.

Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”

She had used fentanyl before coming to the ER and had just enough time to get treated before she needed to go home to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.

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 condition in her limbs was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.

The nurse convinced 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 transitioned to methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.

A short time later, on a day in November 2022, Stephanie had a infant weighing a small weight – premature, little but surviving.

When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.

She felt unwell. Unprepared to be a mother. Not fit.

Stephanie had tried to get clean several times during pregnancy, and felt awful each time she relapsed. She felt hopeless, berating herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her supplier would not provide to her when she became visibly pregnant.

“But I couldn’t,” she said. “I needed help.”

The common assumption that her affection for her child would make her quit only led to deeper self-loathing and self-abuse, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a long-term illness.

The baby was taken to the special care nursery. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would break her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.

Two days later she decided to name her baby after her caregiver, after the nurse who had been so kind to her.

Medical personnel told her about Maddie’s Place, a unique recovery environment 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 newborn addiction symptoms regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like this facility is demonstrating a key fact: when mothers and babies stay together, results get better, foster placements fall and overall savings increase.

It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, two staff members came to pick her up.

She left the medical center still in withdrawal, fearful and unsure about what would come next.

At the care center, Stephanie still feared that CPS would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could arrive and separate them.

For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”

Life on the streets, she said, was about getting by. Substances came first; faith came last.

Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to let her down. She was unable to value herself, let alone anyone else.

Every day, staff from the facility transported her to a treatment center, administered in pill form. Gradually, she was embracing sobriety.

She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all common issues for babies exposed to substances.

When a child recognizes these infants need affection, then I found the strength. I could parent.

One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own children in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.

The young ones stared in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”

She keeps a photo of the moment. She is clad in black pants and a hoodie, a gray knit hat with a pompom on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you cannot see her face. She is lifting the baby on her leg for the children to see and they are gathered around, admiring and touching to the baby.

Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if possible.

“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”

Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could be a mom.”

Methods to address babies with exposure have existed for decades.

The Finnegan NAS scale was developed in 1975|