A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Saved Them Both.

In her eighth month of pregnancy and suffering, Stephanie Rosell went to the medical facility after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.

As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and became sick.

Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”

She had consumed opioids before seeking medical help and had only a brief window to get treated before she had to return to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.

The attending nurse disagreed. She told Stephanie she was not allowed to leave.

“I will go,” Stephanie said.

But the hospital refused to discharge her: the infection in her legs was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.

Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.

A short time later, on a day in November 2022, Stephanie delivered a daughter weighing 4lb 8oz – premature, small but alive.

When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been administered a few hours prior to birth.

She felt ill. Unprepared to be a mother. Unworthy.

Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she was unsuccessful. She felt hopeless, blaming herself for not being able to do the impossible. An doctor 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 pervasive expectation that her love for her baby would make her stop using only led to greater shame and self-abuse, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.

The baby was taken to the NICU. When Stephanie finally saw her her, she was connected to monitors, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.

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

Hospital staff told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.

In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when mothers and babies stay together, results get better, fewer children enter care and overall savings increase.

It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.

She departed the institution still in detox, scared and uncertain about what would happen next.

At Maddie’s Place, Stephanie still worried that CPS would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any point, someone could walk in and take her baby away.

For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”

Life on the streets, she said, was about survival. Addiction 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 lacked the ability to value herself, let alone anyone else.

Daily, staff from Maddie’s Place transported 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 getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had sensory challenges and required an professional – all frequent conditions for babies born with NAS.

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

During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.

The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”

She keeps a photo 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 door behind her. She is slender. Her face is downcast so you miss her features. 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.

Jacob, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if possible.

“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”

Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could parent.”

Methods to address infants affected by substances have been available for years.

The assessment tool was created in 1975|