🔗 Share this article

In her eighth month of pregnancy and suffering, Stephanie Rosell visited the ER after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had built in a companion's property. She was also hooked on fentanyl.

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

Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”

She had consumed opioids before coming to the ER and had only a brief window to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to plan her recovery and deliver her child.

The medical professional intervened. She told Stephanie she was not going anywhere.

“Yes, I am,” Stephanie said.

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

Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.

Five days later, on 12 November 2022, Stephanie gave birth to a daughter weighing a small weight – born before term, tiny yet healthy.

When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her epidural had failed, her last dose of fentanyl had been provided shortly before she gave birth.

She felt ill. Not ready for motherhood. Unworthy.

Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she relapsed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.

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

The widespread belief that her affection for her child would make her quit only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.

The infant was moved to the NICU. When Stephanie finally saw her her, she was connected to monitors, so small she thought she would break her. Holding her for the first time, she felt empty. “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 call her daughter Izzie, after the professional who provided support to her.

Nurses and doctors told her about a specialized facility, a new kind of care center where women and their babies are supported as a unit, not apart.

In much of the US, where a baby is identified with infant withdrawal condition 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 the care home is demonstrating a key fact: when families are kept intact, recovery succeeds, fewer children enter care and long-term costs decline.

It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.

She left the medical center still in withdrawal, scared and uncertain about what would follow.

---

At Maddie’s Place, Stephanie still was concerned that CPS would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could walk in and take her baby away.

For the first two weeks, 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. Drugs came first; trust came last.

Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to let her down. She lacked the ability to love herself, much less anyone else.

Daily, staff from the center took her to a treatment center, provided orally. Over time, 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 daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies born with NAS.

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

During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a mentor, stopped by with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.

The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”

She has an image of the moment. She is clad in casual attire, a cap with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her face is downcast so you do not see her expression. She is holding Izzie up on her knee for the children to see and they are crowding near, fawning and reaching out to the baby.

Jacob, eight, asked the moms: “Why are there no men?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there if possible.

“In the future,” 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 these babies deserve to be loved, then I was able. I would become a mother.”

---

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

The evaluation method was created in 1975|