A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.

Pregnant and experiencing intense discomfort, Stephanie Rosell went to the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also addicted to fentanyl.

As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and became sick.

Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”

She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to figure out how to get clean and have this baby.

The nurse had other ideas. She told Stephanie she was not allowed to leave.

“I am leaving,” 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, Izzie, warned her: if she left, she and her baby would not survive.

Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.

A short time later, on a day in November 2022, Stephanie gave birth to a baby girl weighing a small weight – early, little but surviving.

When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been provided a few hours prior to birth.

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

Stephanie had sought recovery multiple times while expecting, and felt terrible each time she failed. She felt hopeless, blaming herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.

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

The pervasive expectation that her affection for her child would make her stop using only led to increased guilt and self-harm, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.

The infant was moved to the special care nursery. When Stephanie at last met her, she was connected to monitors, so small she thought she would break her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.

Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.

Medical personnel told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are treated together, not apart.

In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like this facility is showing an important truth: when families are kept intact, results get better, fewer children enter care and long-term costs decline.

It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.

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

At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could arrive and remove her child.

For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”

Life on the streets, she said, was about survival. Drugs came first; trust came last.

Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to let her down. She lacked the ability to value herself, let alone anyone else.

Every day, staff from Maddie’s Place took her to a treatment center, provided orally. Gradually, she was starting to get clean.

She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies exposed to substances.

If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.

During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a mentor, came over with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.

The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”

She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a bobble on her head, seated on the ground with the entryway at her back. She is slender. Her face is downcast so you do not see her expression. She is holding Izzie up on her leg for the children to see and they are gathered around, fawning and reaching out to the baby.

A young boy, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there if they could.

“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”

Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I would become a mother.”

Tools for treating drug-exposed newborns have been available for years.

The evaluation method was created in 1975|