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

Pregnant and experiencing intense discomfort, Stephanie Rosell went to the hospital emergency room after her infection worsened up her legs. Without a job or home, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also addicted to fentanyl.

As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and became sick.

Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”

She had used fentanyl before coming to the ER and had only a brief window to get treated before she had to return to use once more. She thought she still had four weeks left to figure out how to get clean and deliver her child.

The medical professional intervened. She told Stephanie she was not allowed to leave.

“I will go,” Stephanie said.

But the hospital refused to discharge her: the condition in her limbs was severe, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.

The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.

A short time later, on the 12th of November, Stephanie gave birth to a baby girl weighing 4lb 8oz – premature, tiny yet healthy.

When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.

She felt ill. Not ready for motherhood. Undeserving.

Stephanie had sought recovery several times during pregnancy, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her source refused to sell to her when she became clearly expecting.

“However, I failed,” she said. “I needed help.”

The pervasive expectation that her bond with her newborn would make her stop using only led to increased guilt and self-abuse, a cause for her to return to drugs. Yet she could not just wish 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 attached to monitors, so small she thought she would hurt her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.

After two days she decided to call her daughter the same as her nurse, after the professional who provided support to her.

Nurses and doctors told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.

In many parts of America, where a baby is found to have newborn addiction symptoms regularly, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, results get better, foster placements fall 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, two staff members came to collect her.

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

At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and take her baby away.

For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”

Survival outdoors, she said, was about getting by. Drugs came first; faith came last.

Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to value herself, not to mention anyone else.

Daily, staff from the center took her to a treatment center, administered in pill form. Slowly, she was embracing sobriety.

She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an professional – all frequent conditions for babies affected by withdrawal.

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

One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a mentor, stopped by with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.

The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”

She has an image of the moment. She is dressed in casual attire, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her posture is humble so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.

One child, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there if possible.

“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”

Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could parent.”

Methods to address babies with exposure have been used for a long time.

The assessment tool was established in 1975|