She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, Stephanie Rosell went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had built in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had consumed opioids 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 several weeks to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” 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 left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
Five days later, on a day in November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she relapsed. She felt without value, blaming herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her source would not provide to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and negative self-talk, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would break her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a unique recovery environment where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when families are kept intact, results get better, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She left the medical center still in withdrawal, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that authorities would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could arrive and remove her child.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. Addiction came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She was unable to care for herself, let alone anyone else.
Daily, staff from the facility took her to a recovery program, given as medication. Over time, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. 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 found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a peer support specialist, visited with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a decoration on her head, seated on the ground with the entryway at her back. She is slender. Her posture is humble so you do not see her expression. She is holding Izzie up on her lap for the young ones to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“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 the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could parent.”
Tools for treating infants affected by substances have existed for decades.
The assessment tool was created in 1975|
