When Gina Decided To Save Herself

Women who are pregnant with opioid use disorder not only need to battle the disease of addiction, but also the stigma that threatens both their lives and that of their unborn children.

Note: No one, it seems, is unaffected by the opioid epidemic. Our hope is that by sharing the pathway to recovery for these women battling the disease of addiction, it may instill empathy for the people in their communities and put the stigma attached to this illness aside. Read on to understand what happens when a pregnant woman using opioids comes to a hospital for help. Please be warned that this piece includes possibly triggering details about one woman’s life experiences.

Part I
Wounded

Gina gently rocks her baby daughter close to her, the baby’s big dark brown eyes look up at her and every so often, slant curiously in my direction. She was born on the same day that Gina’s brother died, but Gina says that someone told her that means he’s an angel watching over her. She has reason to hope that her life—and that of her daughter—will continue to improve eight months after she sought help, but still fears that it won’t.

“Sometimes I don’t know if I’m going to make it,” she said. “Someone in group told a story of a woman who got clean and then started using again. She was shot and now is a paraplegic sipping out of a straw with no clue who she is.” Such is the power of addiction, the disease that claims over 130 deaths every day.

She remembers sitting on Philadelphia street corners in the same clothes she wore for days, waiting for a man to pick her up so she could trade her body for heroin. Occasionally, she would let her mind take her elsewhere to distract her from the painful pangs of hunger and daydream about “the heat from clothing fresh straight out of the dryer or laying on fluffy blankets,” as she recalled in a letter written during a group therapy session. “I’d picture walking to the refrigerator in the middle of the night to capture a pregnancy food craving,” she says. “These images were so real I could actually feel the man of my dreams holding my hands and hear the sound of [my] children laughing.”

In a recurring nightmare, Gina is running by a creek in the park across the street from her childhood home, which she remembers as the haunted house. The reality of what occurred there is much more frightening than her nightmare.

She has pieced together much of her early life from stories that her mother tells her. “I think a lot of the stories my mom would tell me were made up,” she explains. “I never knew my dad, and my mom would say things like, he’s probably dead.” Gina believes that her mother never knew who her father was. “Now I know about the disease of addiction firsthand and I don’t blame her.” Her mother was a believer in free love, socialized in a circle of people that all slept with each other and did drugs, and, according to Gina, traveled the world with a cat.

Gina remembers the day her mom told her and her sister to wake their stepfather for dinner. They smacked pillows against him, not realizing the man had died from an overdose.

Gina was born in 1983 weighing two and a half pounds. Her mother used heroin and methadone throughout her pregnancy, so Gina was released to her grandparents. Later, she was reunited with her mother and they lived in an apartment above a bar in Kensington. One day, Gina’s grandmother came to visit and found a roach in her crib. Horrified, she then bought them a home, the haunted house, in Juniata.

It was in this house that Gina endured verbal and physical abuse. When she was 11, one of her stepfathers molested her and spied on her while she was in the shower. Another beat her for dropping a book too loudly from her bunk bed. Gina remembers the day her mom told her and her sister to wake their stepfather for dinner. They smacked pillows against him, not realizing the man had died from an overdose. She can still remember the stench of animal urine that permeated the home. “My mom wanted all of those wounded animals but didn’t take care of them,” Gina said. “We were all wounded in that house.”

Gina, who said she was quiet and got picked on in grade school, never went to high school. She began selling drugs because she did not want another abusive stepfather around, who at the time was supplying drugs to her mother. Gina was pregnant with her son when her baby’s father was shot and killed. Gina was shot in the face during the altercation. At this point, Gina had only been selling drugs, not using them. In her grief, she asked one of her buyers to show her how to shoot heroin in exchange for five bags of dope. The woman warned her that Gina would likely kill herself but eventually agreed to show her. “I told her don’t worry about what I want to do with my drugs,” she said. “I thought I was going to die [after using for the first time] but instead I just fell into a real deep sleep. I liked it and didn’t stop using.”

A lifetime history of trauma is found in most, if not all, women who misuse substances. Women who use drugs are an extremely vulnerable population and one that is growing, according to Dr. Priya Mammen. “Their addiction makes them more at risk to experience violence, assault, rape, and being forced into prostitution,” Dr. Mammen explains.

Dr. Mammen has been an emergency physician for 14 years; eight were spent at Thomas Jefferson University Hospital and Jefferson Methodist Hospital. She was appointed to Mayor Jim Kenney’s Task Force to combat the opioid epidemic in Philadelphia in 2016. The Office on Women’s Health records that between 1999 and 2015, the rate of deaths from prescription opioid overdoses increased 471% among women — by comparison, the rate increased 218% among men. According to one study, from 1992 to 2012, the percentage of pregnant women admitted to substance-abuse treatment facilities that reported a history of prescription opioid abuse increased from 2% to 28%.

fast facts infographic on opioid overdose
baby laying on bed

Gina has been in the program for eight months and in August 2018 gave birth to a beautiful, healthy baby girl.

After her childhood the rest of Gina’s life has been on the streets. For her, that meant dancing and prostituting herself, being homeless and hungry, going in and out of rehabs and jail. The last time she was in jail, she found out she was pregnant. “I was taken to Jefferson handcuffed and shackled to the bed to be stabilized,” she recalls. “The two cops sat with me all night and then I went back to jail.” After serving her sentence, Gina came back to Jefferson ready to get help. She has been in the program for eight months and in August 2018 gave birth to a beautiful, healthy baby girl. Gina told me that she lives in the fear that she won’t be a success story, that all this fighting will be for nothing and that she’ll relapse. “Sin is a mother humper and because of it, people pay by dying young,” she says.

“For kids that grew up in severe poverty or violent environments, they don’t see anything better or brighter for themselves,” Dr. Mammen says. “It becomes a self-fulfilling cycle and their world becomes much smaller. The stigma of addiction is holding back the help and care that could help save lives.”

“For kids that grew up in severe poverty or violent environments, they don’t see anything better or brighter for themselves,” Dr. Mammen says. “It becomes a self-fulfilling cycle and their world becomes much smaller. The stigma of addiction is holding back the help and care that could help save lives.”

Enter Maternal Addiction Treatment Education & Research, or MATER, historically a methadone treatment program until funding from the City of Philadelphia made it possible to offer buprenorphine treatment. For women who have not had many options in life, like Gina, the introduction marked a watershed moment. “Because we’re a part of Jefferson, there’s a unique pathway to treatment at MATER,” explains Dr. Dennis Hand. “A pregnant person can walk into the emergency room any time of day, seven days a week, and ask for help. Within a matter of hours, they can be triaged into the program.”

Buprenhophine vs Methadone infographic

Stigma and shame keep some woman from coming to the hospital to get help. They fear that they will be judged for their disease and for using while being pregnant, from the people in the waiting room to the doctors who will see them. This series will chronicle what happens when a pregnant woman arrives to Jefferson’s emergency room and through her prenatal care – from intensive treatment at MATER to what happens after the baby is born. They say it takes a village to raise a child, but what about the mother?

Coming soon: Part two continues with how Gina was triaged into MATER.

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