🔗 Share this article

Eight months pregnant and in severe pain, Stephanie Rosell went to the ER after her infection worsened up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a friend’s yard. She was also hooked on fentanyl.

As physicians addressed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and vomited.

Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”

She had consumed opioids before arriving at the hospital and had just enough time to get treated before she needed to go home to get high again. She thought she still had a month remaining to find a way to become sober and give birth.

The medical professional intervened. She told Stephanie she was staying put.

“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 ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.

The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.

After five days, on a day in November 2022, Stephanie delivered a baby girl weighing 4lb 8oz – early, small but alive.

When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.

She felt ill. Not ready for motherhood. Unworthy.

Stephanie had sought recovery several times during pregnancy, and felt awful each time she relapsed. She felt without value, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.

“However, I failed,” she said. “I had to seek support.”

The common assumption that her bond with her newborn would make her stop using only led to increased guilt and self-harm, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.

The baby was taken to the NICU. When Stephanie finally saw her her, she was connected to tubes and leads, so little 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 remained uncertain she wanted to be her mother.

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

Hospital staff told her about Maddie’s Place, a unique recovery environment where women and their babies are treated together, 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 treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is showing an important truth: 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 ultimately reached out. After ensuring she qualified for the program, a couple of employees came to pick her up.

She departed the institution still in detox, anxious and doubtful about what would happen next.

---

At the care center, Stephanie still feared that authorities would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any point, someone could walk in and remove her child.

For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”

Survival outdoors, she said, was about enduring. Addiction came first; reliance came last.

Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to hurt her. She was unable to care for herself, let alone anyone else.

Each day, staff from the center drove her to a recovery program, provided orally. Gradually, she was beginning recovery.

She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an professional – all frequent conditions for babies born with NAS.

When a child recognizes these infants need affection, then I could do this. I could parent.

One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a recovery coach, came over with her own children in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.

The young ones stared in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”

She keeps a photo of the moment. She is wearing black pants and a hoodie, a gray knit hat with a pompom on her head, resting on the floor with the door behind her. She is slender. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are standing close, fawning and reaching out to the baby.

Jacob, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.

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

Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I could parent.”

---

Methods to address babies with exposure have existed for decades.

The assessment tool was developed in 1975|