Nurturing recovering moms
Geisinger staff, patients and a retired OB-GYN work to make sure all patients, including those with substance use disorders, are treated with respect.
Felicia Cohen’s first pregnancy was a “disaster,” according to now-retired Geisinger OB-GYN Gary Stoner, MD.
Ms. Cohen agrees. She was in an abusive relationship and using drugs. Sometimes, when she’d see Dr. Stoner, she would lash out.
He responded with patience and kindness.
It’s common to hear substance use disorder referred to as a disease. But people who misuse alcohol and drugs aren’t always treated like patients with cancer or diabetes. At Geisinger, we’re changing how we care for patients with substance use disorder, especially pregnant women and mothers — from the work of a single OB-GYN to an established program, Free2BMom, to a new initiative using peer support to improve communication and guide people to recovery resources from the moment they step into the hospital.
All of it is just a starting point for a topic we can’t afford to overlook.
Communication and compassion
Fast forward about 8 years, during which Ms. Cohen was on the run from the law, surrendered 3 children to an adopter, used heroin — and successfully sought treatment. When she was sober, in a stable relationship and pregnant again, she returned to Dr. Stoner for care. By then, he was specializing in treating women affected by the opioid epidemic.
Medicine is often referred to as a calling. For Dr. Stoner, caring for patients with substance use disorder is truly a mission. Even today, in retirement, he educates, advocates and shows up to support past patients.
“Every one of his patients gets his personal cell phone number,” says Ms. Cohen. “He listens to us.”
Dr. Stoner remains in touch with many of his former patients. And he and Ms. Cohen give talks on battling the stigma around substance use disorder, especially for pregnant women.
Dr. Stoner also finds tremendous meaning in both aspects of his career, especially watching his patients thrive over time. “It’s been remarkable for me as a provider to see patients who are now married, having children, being employed,” he says.
Communication between patients with substance use disorders and providers can get stuck in an unproductive cycle, he says. Patients using drugs have had bad experiences with law enforcement and the healthcare system, so they’re guarded and defensive. Healthcare providers are frustrated and mistrustful.
“Sometimes, patients are punished for being honest and open,” Dr. Stoner says. So when patients were truthful about substance use or not following his guidance, “I’d say, ‘Thank you so much for being honest with me. You’re doing the right thing. We can help you.’”
Going the extra mile
On a cold winter day, Markie Troutman and Valerie Andreoli, with Geisinger’s Free2BMom program, are packing up their cars to travel to a court date. They’ll meet another colleague there to advocate for a mother whose children are at risk of being placed in foster care.
“We’re going to present a united front,” says Ms. Troutman, Free2BMom program manager.
She and Ms. Andreoli, a case manager, feel confident in supporting the mother — because they know her well. Free2BMom is an intensely hands-on support system for moms who have substance use disorder and young children.
“We meet moms where they’re at,” says Ms. Andreoli. “We get them the resources they need.”
“Sometimes this is a disposable population,” adds Ms. Troutman, who is in long-term recovery.
Both say that many of the women they serve are just kids themselves. They come from all walks of life, but many have been abused or lacked positive role models.
The program, which serves Columbia, Luzerne, Montour, Northumberland, Snyder and Union counties, is grant funded, and the money is used for everything from diapers and wipes to books that moms can read to babies.
“We can go into jail where attorneys can go,” says Ms. Andreoli, so mothers have face-to-face support during some of their most challenging times.
Experience leads to understanding
Some of the Free2BMom staff are certified recovery specialists (CRS) — which means they’re in recovery themselves.
Recently, Geisinger has expanded CRS use to Geisinger Community Medical Center through the Substance Use Navigator program, led by Franca Dalibor. When a patient arrives at the emergency room with signs of substance use disorder or a positive screening, they’re offered the chance to meet with a CRS.
“It’s a beautiful thing because it’s peer support,” Ms. Dalibor explains. “Sometimes it’s just a conversation. But the goal is to get them into treatment.”
She adds, “Lived experience. That, and our tremendous ER staff, are the key behind the whole program.”
Like Dr. Stoner and her colleagues in Free2BMom, Ms. Dalibor says the challenges of helping people navigate substance use disorder are outweighed by the rewards.
“There’s something about the work that’s gratifying that you can’t even imagine,” she says. “It’s that human connection.”
Forging that bond can make all the difference in a patient’s life, according to Ms. Cohen. “We are our own person, on our own path,” she says. “We just need more people’s help.”
This story originally appeared in the spring issue of PA Health, our quarterly full-color magazine filled with wellness tips, inspiring stories and more.
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