You can read the transcript below or listen to the audio file by clicking here.

Jaworski: Hi and welcome to Adoption Focus. My name is Jennifer Jaworski and I’m a social worker with Adoption Associates of Michigan. This is Adoption Associates Premier Talk Radio Blog Show. Adoption Associates and its staff are trusted leaders in adoption and we have placed well over 5,000 children into loving homes.

 Since 1990 we have advocated, supported and nurtured both birth families and adoptive families. And helping families and birth parents grow through the process is very important to us. Our offices are located in Jenison, Lansing, Farmington Hills and Saginaw. And out pregnancy and adoption services are available throughout Michigan.

Adoption Associates of Michigan is this weekly radio show. So thank you so much for listening today. We do hope that you find this forum to be inspirational, educational and thought provoking. If you’d like to call in during the show, with questions or comments, we would love to hear from you at (347) 850-1100. Again (347) 850-1100 is the number to call in with questions or comments.

And today I am excited to welcome to our show, Shawnteal Pernell. Shawnteal are you with us?

Pernell: Yes.

Jaworski: Good morning.

Pernell: Good morning.

Jaworski: Thanks so much for taking time out of what I know is a very busy schedule for you to be with us. You are a social worker at Beaumont Hospital of Dearborn, formerly known as Oakwood Hospital. And you are very busy pretty much all of the time, so once again-

Pernell: Absolutely.

Jaworski: We’re so glad that you’re with us. Could you just get us started off today by sharing a little bit about yourself and what you do?

Pernell: Well, I’ve been a social worker for about twelve years now. I started out in juvenile justice then moved on to home based services. And now I’ve been in the hospital setting for about the last nine years, although I perform social work duties on various units in the hospital. I particularly love the mother/baby, labor and delivery, the neonatal intensive care unit. What can I say? I love babies, love working with Moms and parents. As crazy as it may sound I do enjoy the unpredictability of my job. When I walk in every morning, I just never know what type of day I’m going to have, so I do very much enjoy that adventure.

Jaworski: That’s awesome to hear. You’re where you belong it sounds like.

Pernell: Absolutely.

Jaworski: That’s so great. Could you please talk about your role and how you assist when there is a woman at the hospital who’s making an adoption plan.

Pernell: Well the first thing I do when I do meet with a mother is, I work to immediately build a rapport with the Mom. Just so I can demonstrate to her that I understand that this is a scary as well as a confusing time. I want that birth Mom to feel that if, only for a short time, that they’re in the hospital, that I am their advocate and that I am here to support them. Many times in the hospitals it’s quite faced paced even with me working with them and things that they have to do. So I consider it to be my job to make them feel less rushed especially when it comes to paperwork and procedures and all those different things that can go pretty fast. I just want them to feel comfortable.

Jaworski: That’s really important. That’s good point that you make. So many of our clients talk about how short their time is in the hospital and how many things are happening, so nice to hear that. And you also coordinate with the adoption agency all of those things that need to happen, correct?

Pernell: That is correct.

Jaworski: Adoptive families who are maybe invited to be at the hospital by the birth mother would have contact with you as well the agency staff person that are helping put this adoption plan together on behalf of the birth mother. What are some of the challenges that you’ve witnessed for birth mothers at the hospital when they’re making their adoption plans?

Pernell: Well quite naturally, there are quite a number of challenges. The biggest one that I see is the family influence. I find that it is … not less difficult to make the decision when the baby’s … before the baby is born; however, once the baby arrives, family influence is really big. Sometimes I’ll have families that’ll come in and see the baby. The baby is beautiful. The baby’s handsome. And then there’s a guilt placed on the birth Mom for making such a decision. They may come with negativity, ridicule. Sometimes there are promises of home support if the baby is kept and in turn that causes the birth Mom to begin to doubt herself. Thus making that adoption process more difficult to cope with. At that time again, my role is to come in and to comfort that Mom and to assure her that this is a good decision and express to her that she needs to be confident in what she’s doing as well.

Jaworski: And when you mention families, you’re not referring to adoptive families. You’re talking about the birth mother’s family?

Pernell: Exactly.

Jaworski: That’s coming in. They’re a bit of an outside influence okay.

Pernell: Exactly.

Jaworski: What are some of the other challenges that you see?

Pernell: Another challenge I would see is substance abuse during pregnancy. During this day and age especially in the area that I work in substance abuse is becoming to be a huge issue. Addiction is a disease and unfortunately many, well some of our Moms, are deep into their addiction and not even a pregnancy acts as a motivator for change. Whether it be from a friend, associate, or you know doctor’s office, sometimes they’ll learn of the option for adoption and then sometimes they’ll conclude that that’s the better option versus the services taking that child and placing them in foster care. And Child Protective Services also appreciates that plan as well.

Jaworski: Yeah I’m glad that you brought up the Child Protective Services piece cause that is something that we do see in cases where there’s substance use and I know that sometimes there’s confusion about what that means because here’s an adoption agency already involved and now there’s CPS. A lot of angst sometimes with the birth mother or the adoptive parent in understanding that. What are you seeing in terms of those relationships and how they play out when there is an adoption agency and a birth mother making a plan and then CPS comes in because of the report of substance use or positive testing?

Pernell: Child Protective Services is usually very cooperative. Again, they appreciate the fact that the mother has taken responsibility and has put a plan into place. I think it makes their job a bit easier. Quite naturally, they still may follow the case for a little while, but they’re awesome about working with an adoptive family, making them feel comfortable as well. And again applauding the mother for that plan, but also looking for her to support any services that she needs to help with her addiction as well.

Jaworski: You mentioned about, basically we’re talking about substance use prenatally. So I think that’s important for us to take [inaudible 00:07:31] as you mentioned with being aware of a new trend. Now in Michigan, but throughout the country, addiction during pregnancy. Can you talk about what you’re seeing there at your hospital?

Pernell: Well particularly in my hospital, I’m seeing a huge number of cases that involve prescription drug abuse. Also seeing incidents of heroin use throughout. There are occasions where you see marijuana. Prescription drug use and heroin is really big right now. In regards to babies that are going through withdrawal, some of the symptoms that we’re seeing include irritability, poor feeding, loose stools, skin breaking down on their chin or their buttocks and it’s particularly hard to deal with sometimes. But it’s one of those things that we have to work together to get through and just recognizing that this is a problem for people.

Jaworski: Right and there is proper treatment. And you have the staff, obviously, to help manage that clinically speaking. What are pediatricians at your hospital saying to the families of these babies that were critically exposed to either heroin or prescription drugs? What should families know, adoptive families?

Pernell: Adoptive families should know that first of all there is support out here for these babies. The way we treat those babies are, in our neonatal intensive care unit, where the babies are placed on medication in order to help them get through the withdrawal. As far as the effects, short term effects, again, the symptoms that I described earlier. But we invite the adoptive families to be a support to those babies. Support can include visiting with the baby, swaddling them, holding them, speaking to them. Just showing them that special attention just so they know that they’re loved from the very beginning.

Jaworski: Sure, sure. We talked a bit ago about signs that the baby may show while withdrawing. There’s a lot of information available that we can put into the hands of our families or those maybe interested. Can you tell us a little bit about the scaling system, the Finnegan scale that’s used in the NICU for assessing the babies?

Pernell: Okay, sure. Like I said, the scale is the Finnegan, better known as the neonatal abstinence scoring scale. Each symptom again, the irritability, loose stools, poor feeding, they’re all assigned a number that’s included with that scoring. And those numbers, usually they like the scores to be under eight. If the child’s symptoms are higher, they have higher numbers. For instance, anywhere from 12 to 17. Those scores and the symptoms are managed by morphine. Usually it’s what they give the babies. Then get the babies off of the morphine and get their symptom score down so that they can be deemed medically stable for discharge.

Jaworski: And those scoring are what determines the proper medical treatment. Is that correct?

Pernell: Exactly, exactly and usually we’re seeing babies that are … they may be on morphine anywhere from two weeks to four weeks depending on the substance that was used. I have had instances where babies are in the hospital for two months but that’s not the usual case though.

Jaworski: What about what families can do, the adoptive families can do, to support their baby or help during this time. I know you mentioned swaddling, but even as they go home from the hospital, what are the recommendations?

Pernell: I would say to follow up with the pediatrician on a regular basis. The biggest part is to stay calm. Don’t want to scare anyone away from that, but just being informed to do their own research, to keep in touch with the pediatrician. Just so they’re educated on what to look for, signs and symptoms. But usually when the babies are discharged from the hospital they are pretty stable.

Jaworski: I wanted to shift our focus back a little bit to the birth mother. We were talking earlier about the major challenges that birth mothers face after delivery and as they begin to think emotionally and physically about handling, handing, excuse me, their adoptive child over to the adoptive parents. This is obviously a very difficult time for the birth mother even though she generally has decided that this is the best decision for her child. In your experience at the hospital, how can adoptive parents support the birth mother during this very difficult time?

Pernell: I would say the biggest way that they can provide support is to provide the mother with encouragement. Compliment her. Encourage her. Let her know that you acknowledge her strength to make such a courageous decision. Assure that mother that the baby will be very well taken care of and also give the Mom time to say goodbye or to share in a special moment, like the first bath, the pictures. And that’s if she wants to. The biggest thing is just give her that space. Give her that time to just share in that.

Jaworski: And I know before the show you and I were talking off air about some of the situations that you’ve seen when we wish things had gone differently at the hospital and so I wanted to touch just for a second if we could about some of those issues. It’s a difficult time and we’re advising adoptive families, as you just said, to give her some space and give her some time. But emotions are heightened for adoptive families, feeling fearful that maybe she’s changing her mind. Birth mother is feeling like she’s not getting alone time. Talk about what that looks like, what you see. Because you’re viewpoint is from a very different place in both the birth mother and the adoptive parents. What that looks like, how to manage that and what adoptive families really could do during this difficult time to make it better.

Pernell: Well you are absolutely correct. Usually I am at the center of any challenge that may occur. In instances where I’ve seen where the birth Mom is feeling maybe crowded by an adoptive family, she will pull me to the side and have me come in and speak to her. And I’ll try to give her the perspective of the adoptive family, but I’ll also verbalize that I understand her feelings as well. In those instances, then I’ll go speak to the adoptive family. Let them know how Mom is feeling, be an advocate for her. And then try my best to be a middle ground in between the two even if it’s, I give the adoptive family perhaps some ideas of places to eat around the hospital or to occupy their mind while we’re giving the birth Mom time to do what she needs to do and feel comfortable in her decision as well.

Jaworski: Oh I’m sorry Shawnteal. We missed our connection just for a second there. I was talking about how important your role is in helping navigate the emotional complexities at the hospital and so much that’s going on. Are you involved in every adoption case at your hospital?

Pernell: Yes. I’m involved in every one. The nurses or the doctors, if I’m not aware of a consult coming in, they will certainly let me know and then I’m involved from the beginning to the end.

Jaworski: I think that we had a connection issue there a minute ago and I was kind of speaking for a moment. I don’t know if that came through or not. But from the adoption agency perspective and from the adoptive parent perspective, I know that we view your role as so important to helping put all the pieces of the puzzle together. So for an adoptive family or a birth mother who find themselves at the hospital and maybe needs some support, they should ask to speak with a hospital social worker or even if not at your hospital, that would be the role of that person, correct?

Pernell: Oh absolutely. The social worker is the point person for the resource even if it’s not related to the logistics of adoption, paper work, meeting or anything like that. If the Mom just wants to share a cry, a yell, a anything like that, a good social worker always makes him or herself available for that birth Mom.

Jaworski: Absolutely. Well I appreciate, again, you taking the time out today and we’ve touched on some important subjects. Prenatal substance exposure is something that we’re seeing more of as well as an increase in substance use, prescription as you said, as well as heroin. Adoption Associates continues to educate not only our staff, but our families about these issues as well as the importance of providing loving homes to these babies. Hopefully you and I can be in touch again somewhere down the road and get an update about where we’re at with this issue of substance exposure and maybe some new things that are to come with the proper treatment of children. Thank you so much Shawnteal, for today.

Pernell: No problem. Thank you.

Jaworski: And for those of you that are listening, remember that we are live on Tuesdays at 11:00am here on Adoption Focus. We would love to hear from you if you’d like to connect with Adoption Associates, you may call us at (800) 677-2367 or visit us on the web at I hope that you can join us next week when we’re speaking with a Mom by adoption regarding international adoption programs. Please tune in. For now, this is Jennifer on Adoption Focus. Have a great day everyone. Bye Bye.