A Form Of Activism

Disclosure – I have not read this book but I will admit I am intrigued by it. My first awareness was a mention in my all things adoption group – Barbara Kingsolver’s novel Demon Copperhead is the story of Appalachia from the viewpoint of a kid in foster care. Excellent book. Trigger Warning for folk who have been in neglectful or abusive foster care situations.

So I went looking. There is much about this that hits close to home – as in Kentucky is next door to my home state of Missouri and one learns to watch out for Copperhead snakes here. The opioid crisis and unwed teenage mothers, as well as abject poverty, matter to me. I find the Oprah has chose this book for her book club, LINK>Oprah’s Book Club Author Barbara Kingsolver Writes the “Great Appalachian Novel.” An interview there with the author gave me today’s blog title. Barbara Kingsolver’s writing is a form of activism, of righting wrongs. She wanted to address an injustice. Demon Copperhead is a social novel.

In the interview, the author says – I’m committed to writing honestly and respectfully about this region that is widely ridiculed or just invisible in mainstream American culture. Appalachia is beautiful and culturally rich, but a long history of exploitation has left us with structural poverty, limited opportunities, and educational deficits that outsiders tend to laugh at. In the latest of these tragedies—the opioid epidemic—pharmaceutical companies deliberately targeted us for their poison pill. Seeing the devastating effects here where I live moved me to look for the bigger picture and write about it.

In retelling Dicken’s David Copperfield, a boarding school for indigent boys becomes a beleaguered tobacco farm where foster boys are brought in to do unpaid labor. A shoe-black factory is a meth lab. The dangerous friend Steerforth is now “Fast Forward,” a high school football star with a narcissistic streak. Et cetera. She notes – A scary percentage of the kids in my region—as high as 30 percent—have lost their parents to prescription drug abuse. They are wards of the state, or are living with grandparents or others who might prefer not to be raising them. That’s the case with my fictional hero, Demon, and his ragtag band of friends. They want so badly to be seen, in a world that wants them erased.

When asked if she had a special interest in foster care, she replied – To write about a modern generation of kids orphaned by poverty and addiction, I had to dig in and understand the systems that support them—and those systems are inadequate. I was stunned to see how inadequate. DSS workers are absurdly underpaid. Turnover and caseloads are such that a child may not even know the name of his legal guardian, and vice versa. Cruelty and abuse are ongoing options. By telling some awful truths in the story and voice of Demon, maybe I can engage some hearts and minds to make a difference.

There is also a review in The Guardian – LINK>Dickens Updated. From that review – Kingsolver’s hero Damon Fields, known as Demon and nicknamed Copperhead for his red hair, is born to a drug-using teenage single mother in a trailer in Lee County, Virginia. Even in this deprived neighbourhood they stand out by being almost destitute, living between a coal camp “and a settlement people call Right Poor”. Since his mother is in and out of rehab, Demon is partly raised by the sprawling, warm-hearted Peggot clan. It’s all there in Dickens: the weak, infantile mother, ripe for abuse; the dead father and the disciplinarian boyfriend turned merciless stepfather; the bad odds against which no child stands a chance – and also the outsiders, some loving and others less so, who offer only a limited form of help.

Demon becomes a casualty of the “monster-truck mud rally of child services”: case workers who don’t read his file; foster parents who are only in it for the security cheque. Where David is packed off to gloomy Salem House, run by the sadistic Mr Creakle, Demon is quite literally farmed out to “this big old gray-looking house, like Amityville”, owned by a tobacco farmer called Crickson. Demon’s battle to achieve sobriety and to transcend the failure of those around him “to see the worth of boys like me, beyond what work can be wrung out of us by a week’s end. Farm field, battlefield, football field.”

The Impact of the Opioid Crisis on Adoption

“I always like to tell everybody we raised yours, mine, ours, my brother’s, now others.” ~ Suzanne Valle

The opioid crisis has strained child welfare systems in recent years, as kids who often face neglect and abuse are taken from their families and put into foster care. Jesus and Suzanne Valle thought they would become empty nesters indulging in their love of travel but they became adoptive parents instead. From 2007 to 2018, they took in six children, all from Ohio families struggling with addiction, including their own. Four are the kids of Suzanne’s brother, and two kids came through the foster care system. They had already raised nine of their own biological children.

The above is courtesy of StoryCorps and NPR. I also found this first person account – What Happened After I Tried to Adopt an Opioid-Dependent Baby from Washingtonian written by Susan Baer for Carrie Brady, a longtime employee at Google.

She was 40 and single when she decided to adopt a baby. Because of America’s opioid crisis, her chances of finding a match were better if she agreed to accept the child of someone addicted to drugs. She had received a call from the adoption agent for the baby she expected to adopt. The mother had hemorrhaged and given birth in an emergency C-section, actually five days earlier. The baby had aspirated blood and been without oxygen, then helicoptered to a hospital in the mother’s home state, down south, and might not survive.

Her whole rationale for adoption was to be the best mom for whatever baby she was matched with. But now she found herself confiding to her sister, “I worry that if this baby survives with major brain damage, it was going to be too much for me.” She prayed about it and hoped the baby would somehow lead her to the answer. She asked her adoption agent, “Do you ever have families looking for special-needs babies?” She said, “Yeah, I do.”

She knew adopting a baby on her own would throw her tidy life into disarray. Her mother asked repeatedly, “Why do you want to uproot your life like this?” She simply felt she could give a different sort of life to a child born into tough circumstances. Reminds me of my own father, when my husband and I decided to have children (thanks to assisted reproduction) at an advanced age, “I question your sanity.” That has come back to me a few times.

The baby was taken off life support and was going to die. She wanted the baby girl to be baptized and so a chaplain was called. The nurses brought her a dress and booties. Carrie was able to hold the baby girl the only time she would ever be held. Carrie says, “I told her why she was here and how sad I felt. I promised to remember her.” For the first time, there were no sounds. The room was still.

The first thing she learned was that if she wanted to be an adoptive mother anytime soon, meaning within two years or so, she’d have to consider a baby who might have some drug dependency. Over the last several years, because of the opioid epidemic, a growing number of infants placed with adoption agents in the US (as many as 60 or 70 percent at some agencies) have had exposure to drugs or alcohol in utero, mostly opioids or treatment drugs such as methadone. Methadone is a very powerful drug given to help keep addicts off of heroin and other related opioids. The opioid crisis has had such a profound impact on the adoption landscape that placement agencies provide classes on prenatal drug exposure so that prospective parents can decide whether it’s something they can handle.

Adoption is a control freak’s worst nightmare and with an addicted birth mother, it can be nerve wracking. It is excruciating to have such a tenuous grasp on something as important as adopting a newborn and hard not to read too much into every unanswered text or canceled date. Her adoption consultant told her, “It’s not a bad thing to be all in.”

Two months after the baby girl died, her adoption agent called with the news: Another birth mother, also from the South, had chosen her profile and was having a baby boy at the end of the year. She was also in a methadone treatment program for a drug addiction (same as the first birth mother). The adoption agent cautioned her, the birth mother had been expected to place her last child for adoption but had backed out after the birth and chose to keep the baby.

This birth mother had been on methadone for three years, it was likely her baby would be dependent. The detox period could last weeks to months. Carrie was there for the baby’s delivery. He weighed 6.9 pounds and was 20 inches long. She was allowed to cut the cord and was the first to hold him. That night had been stormy with the birth mother. However, the next day when she arrived at the hospital, the birth mother was holding her infant son. They looked so peaceful. Carrie told her, I just want the best for him and would love her, even if she wanted to change her mind. She didn’t.

In NICU, the baby’s blood had a higher concentration of red blood cells than was normal, a condition that can result from maternal smoking. He was getting fluids through an IV but might need a blood transfusion. Thankfully, the fluids resolved the issue and the baby avoided a transfusion. But his withdrawal symptoms were escalating. His crying wasn’t like any baby’s cry she’d ever heard. Imagine the screams of someone being tortured. That’s what it sounded like—pure anguish—and nothing would stop it. With his symptoms worsening, doctors decided morphine would allow him a little relief.

When they weaned him from the morphine, the withdrawal came back with a vengeance. She finally got him into his crib with the sand weights, pulled down one side of the crib to lay her head down next to his. She started singing to him the country song she’d listened to on her morning walks to the hospital: “Everything’s gonna be alright. Nobody’s gotta worry ’bout nothing. Don’t go hitting that panic button. It ain’t near as bad as you think. Everything’s gonna be alright. Alright. Alright.”

He finally improved enough to be discharged. The nurses assured her that best thing for him was to be home. “It’s the nurture part that gets these babies through,” they said. For two more months, the baby struggled through withdrawals. Crying sometimes for hours on end, clenching up his face and body, and appearing mad at the world for many of his waking hours. He rarely slept more than two hours at a time, and once he started crying, it was hard to get him to stop.

At three months old, he got better and would take a pacifier to soothe himself. He started sleeping three and four hours at a time and then through the night. She never heard that awful cry of pain again. Besides normal pediatrician visits, he was seen monthly by a developmental therapist, who dismissed them after about a year. He had hit all of his milestones and showed no signs of any delay.

The Goal Is Reunification

Think Foster Care is your avenue to an infant adoption ? Better revise that thinking because the goal of foster care is the reunification of the original family members. Here’s what one hopeful adoptive mother (using foster care to achieve her goal) wrote –

“Just out of curiosity how many of you have had baby placements and have either adopted or planned to adopt them? We have lost hope that we will ever get a baby, plus our region has pretty much said there are no babies that get adopted here. Can you also post what region you’re from, I’m try to see if maybe certain regions have better luck”.

Sure, it can be hard on the foster family to say goodbye to a child they loved.

Children are removed when the situation they are in is one that is unsafe. Each foster care case begins with the goal of reunification. Parents are given goals to meet in a timely manner to be reunited with their children. Most children are able to return home to their families. There are instances in which the parent has their parental rights terminated, and then the child is placed for adoption. Reunification is the goal and must be pursued when possible and safe for the child.

There is no guaranteed time frame for how long a child will remain in foster care. Some cases are short-term cases and can result in reunification after a few weeks, while other cases can go on for years. When the time frame turns to years, the case plan may become one of reunification with the concurrent plan of adoption. In that situation, the state is acknowledging that the case plan is taking a significant amount of time and that the parents may not be able to complete all the tasks. At that time, the child is considered at legal risk and may be placed into a pre-adoptive foster home. A pre-adoptive foster home is one in which the foster family has expressed interest in pursuing adoption, and is home studied and ready to do so. While each case is different, a general rule of thumb is that if a child has spent 15 months in foster care, it is time to reassess and decide how to proceed, and if adoption ought to be added as a potential goal.

While parents are working on the reunification of a child, they will also (as safety allows) participate in visits with their child during this time. Visitation may be supervised or unsupervised, depending on the reason for the removal of the child from the home. In more extreme cases, where a child’s safety is in question, there may be a court order that prevents visits until the court can be assured that visits will be safe for the child. In these cases, parents may need to complete certain steps before being allowed contact with their children. The most important thing is to be sure the child is safe.

Because being removed from their parents is a traumatic event, social workers are required to try to find a kinship placement for children. Kinship placement is any home where the caregiver has a relationship with the child and is not a stranger. Typically, kinship care refers to placing the child with a relative. However, teachers, family friends, and others who the child may be familiar with can be considered. A child will be more comfortable if they are familiar with their caregiver, and far less stressed. Kinship care is not always possible, however, and that is why there is a need for licensed foster homes.

So, going back to the beginning, it appears that another woman was sympathetic and wrote – “We ALL know that some of the kids we have will reunify and we all should know that reunification is not a reality for some babies and kids and they will need adoptive families. If anything most babies shouldn’t be reunited. Obviously MANY families here are praying that they can adopt! I feel like some of you are going out of your way to squash their dreams! They know what the journey can hold! We should be building them up and encouraging them. NOT every case ends in reunification. Actually the national statistic of reunification is only 49% percent there’s a ton of children needing homes! Our county has a lot of drug babies and junkie parents because of the opioid crises. Many foster parents can adopt a baby.”

So there is that.

She goes on to suggest – “We were upfront and told the caseworker we only wanted cases that had a chance of moving from Termination of Parental Rights (TPR) to adoption. Both of my babies are miracles and our first placement. We went into foster care TO ADOPT. There’s nothing wrong with adopting. Reunification shouldn’t be the goal. The goal should be about whatever is in the child’s best interests. Stop ruining people’s dreams of adopting. Many babies cannot go home. I have another baby right now who is heading towards TPR. Reunification isn’t an option. No need to remind us that reunification is the goal. We ALL know that.”

Maybe, but clearly – reunification is NOT the goal for some foster parents – adopting a baby is their goal.

Historic Reforms Keeping Children With Family

Only today thanks to a piece in the most recent Time Magazine, I discovered that one of the reforms I often advocate here became law in October 2018. The bipartisan legislation allows states to use federal funding to help struggling parents before resorting to putting children in foster care. Congress recognized that too many children are unnecessarily separated from parents who could provide safe and loving care if given access to needed mental health services, substance abuse treatment or improved parenting skills.

“If we can get more children being raised in a family-like setting, either with their parents or extended family, it bodes well for what happens in this country in the long run.”
~ William C Bell, Casey Family Programs

Nearly half a million children are currently in foster care. After years of decline in numbers of children in foster care, the number has risen steadily since 2012, with anecdotal evidence and expert opinion linking this increase to the parallel rise in opioid addiction and overdoses. Family First provides struggling and overburdened child welfare agencies with the tools needed to help children and families in crisis, including families struggling with the opioid epidemic.

Young people involved in the child welfare system do best in families, in a safe and stable environment that supports their long-term well-being, according to research. The passage of Family First took a large step toward this vision by restructuring how the federal government spends money on child welfare to ensure that more children in foster care are placed with families. The law also provides more support for critical services, such as mental health and substance abuse treatment, in-home training and family therapy that can help prevent the need for foster care in the first place.

The law gives states and tribes the ability to target their existing federal resources into an array of prevention and early intervention services to keep children safe, strengthen families and reduce the need for foster care whenever it is safe to do so. It also provides federal funds for evidence-based Kinship Navigator programs that link relative caregivers to a broad range of services and supports to help children remain safely with them, and requiring states to document how their foster care licensing standards accommodate relative caregivers.

There will no longer be a time limit on reunification services for a child in foster care preparing to return home, and a child returning home will now have access to 15-months of family reunification services beginning on the date the child returns home. It’s a start.