She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.

Pregnant and experiencing intense discomfort, Stephanie Rosell went to the medical facility after her infection worsened up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had assembled in a companion's property. She was also addicted to fentanyl.

As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and threw up.

Stephanie finally broke down. “I need to leave. I have to go home and get high.”

She had taken the drug before arriving at the hospital and had only a brief window to get treated before she had to return to use once more. She thought she still had a month remaining to plan her recovery and give birth.

The attending nurse disagreed. She told Stephanie she was staying put.

“I will go,” Stephanie said.

But the doctors would not let her go: the leg infection was serious, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she walked out, she and her baby would not survive.

Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.

A short time later, on a day in November 2022, Stephanie had a infant weighing a small weight – born before term, tiny yet healthy.

When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her epidural had failed, her last dose of fentanyl had been provided four hours before delivery.

She felt ill. Not ready for motherhood. Unworthy.

Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she was unsuccessful. She felt hopeless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her source would not provide to her when she became clearly expecting.

“Yet I was unable,” she said. “I required assistance.”

The pervasive expectation that her love for her baby would make her stop using only led to deeper self-loathing and negative self-talk, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.

The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I gazed upon 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 give her child the name after her caregiver, after the nurse who had been so kind to her.

Nurses and doctors told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.

In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like this facility is proving a simple point: when parents and infants remain united, results get better, fewer children enter care and future expenses reduce.

It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, care providers came to bring her to the facility.

She departed the institution still in detox, fearful and unsure about what would follow.

At Maddie’s Place, Stephanie still worried that child services would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could enter and take her baby away.

For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”

Life on the streets, she said, was about survival. Substances came first; faith 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 did not know how to care for herself, much less anyone else.

Every day, staff from the facility drove her to a recovery program, given as medication. Over time, she was starting to get clean.

She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all common issues for babies exposed to substances.

Seeing that even a young person understands the need for care, then I was capable. I could be a mom.

During a pre-holiday visit, Stephanie was in the common room, 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 deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.

The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”

She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her leg for the young ones to see and they are gathered around, admiring and touching to the baby.

Jacob, eight, asked the parents: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, that they would be there given the chance.

“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”

Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could be a mom.”

Approaches for managing drug-exposed newborns have been available for years.

The assessment tool was established in 1975|