She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.

Pregnant and experiencing intense discomfort, Stephanie Rosell arrived at the hospital emergency room 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 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 became sick.

Stephanie finally broke down. “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 was compelled to leave to get high again. She thought she still had four weeks left to figure out how to get clean and have this baby.

The nurse had other ideas. She told Stephanie she was staying put.

“I will go,” Stephanie said.

But the medical facility declined to release 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 face grave danger.

She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.

After five days, on 12 November 2022, Stephanie delivered a infant weighing a small weight – early, tiny yet healthy.

When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been administered shortly before she gave birth.

She felt sick. Ill-equipped for parenting. Not fit.

Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she relapsed. She felt worthless, blaming herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her supplier declined to supply to her when she became visibly pregnant.

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

The common assumption that her bond with her newborn would make her recover only led to greater shame and self-abuse, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.

The baby was taken to the NICU. When Stephanie finally saw her her, she was connected to medical equipment, so small she thought she would hurt her. Cradling her initially, 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.

After two days she decided to name her baby Izzie, after the attendant who showed compassion to her.

Medical personnel told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.

In much of the US, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and long-term costs decline.

It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, care providers came to pick her up.

She stepped out of the hospital still in recovery, scared and uncertain about what would come next.

At the care center, Stephanie still was concerned that child services would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could arrive and take her baby away.

For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”

Survival outdoors, she said, was about enduring. Drugs came first; reliance came last.

Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to let her down. She lacked the ability to value herself, much less anyone else.

Every day, staff from the center took her to a recovery program, provided orally. Over time, she was beginning recovery.

She devoted all her time 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 pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all frequent conditions for babies exposed to substances.

Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.

One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits 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 awe of the little newborn 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 keeps a photo of the moment. She is dressed in casual attire, a cap with a decoration on her head, sitting on the wooden floor with the door behind her. She is thin. Her face is downcast so you cannot see her face. She is presenting her daughter on her leg for the young ones to see and they are crowding near, admiring and touching to the baby.

Jacob, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the men were occupied, handling responsibilities, 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 will teach them about love.”

Stephanie and her companion looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I would become a mother.”

Methods to address babies with exposure have been available for years.

The Finnegan NAS scale was developed in 1975|