Seeking A Different Outcome

A woman lost her firstborn child to Child Protective Services when she was 17, after having been abandoned by her abusive father. Part of the reason for losing the child then was poverty – no crib or medical insurance. She also had untreated mental issues. She has been in therapy since she was 18 and her therapist will support her now – 6 years later. She is now 3 1/2 months pregnant with her second child and understandably afraid of losing this child as well or that they’ll bring up her mental health issues from the past. This child’s father is not the same one as her first child’s father and is supportive of her. She gets SSI income and her boyfriend is a line cook. Because they are on a tight budget, she is buying what she can in preparation for her baby, as she can. How can she avoid a repeat experience ?

A response came from a woman who works in primary care settings. She has seen cases where if the parent previously lost a child to the Div of Health Services, that parent comes under heightened scrutiny. Suggestions – If you are going a regular OB clinic or community clinic, show up for every single prenatal appointment, stay on top of scheduling. Make them aware of the regularity/consistency of your therapy appointments. I personally would not meet with or trust their social or behavioral health person – keep them at arm’s length until you get a good read as to whether they seem genuinely interested in helping with you. It seems you have good support already, so don’t even go there. If you feel you have to appease them and must meet with one, just be prepared to say all the areas you have covered already. Don’t express vulnerability or what you don’t have. Better to go through trusted community organizations if you need physical items, housing resources, etc. Expect to have to do a Urine Analysis at some point. Avoid using any substances including marijuana that might get you flagged.

I am a big fan of midwives and so I liked this suggestion – seek out a birth center or better yet a home birth midwife. You can meet them for a consultation (no pressure to pick that one). Wait until you find one you think you could have a trusting relationship with. They won’t have access to all your medical records. They are more focused on supporting you as an individual. The less contact with nosy/intervention happy medical people, the better in your case. If you end up needing to birth in a hospital, a good midwife ought to be a good advocate for you in that setting, even though it is also a high risk setting for Div of Health Services involvement/hospital staff scrutiny.

If she is in a conventional medical care setting, the woman suggests be one step ahead with all the baby item planning. Having the car seat well in advance, like by 30 weeks, and schedule a car seat installation safety check (you can find them by searching “car seat safety clinic” they are often done at fire departments). If she signs up for WIC (which pays for formula), she needs to be aware that they are another scrutinizing entity that could represent a threat.

The biggest poverty factor to control for is housing stability. If you rent, is your lease month to month or year long? Being on good terms with your landlord can smooth inspections. Best have a Plan B. Make certain savings could cover a move, if needed. Or have a support network, one that would allow you stay with a stable family that is considered “safe”.

Additional suggestions from another with behavioral health work within a primary healthcare setting – No one can report a thing until the child is born. Be careful about what releases you sign. No one can talk to anyone about you without your release – unless it becomes a mandated report. If you sign releases, you are at risk. Therefore, any releases need to be very specific. Don’t sign blanket things like “service coordination.” Instead say what services you want coordinated.

This woman disagreed with some of the previous advice – I don’t agree with universally declining behavioral health services, because those services can be helpful for connecting with community based programs for things like car seats, help with food insecurity, clothing, etc. If your ongoing therapist is well connected, and knows what programs are available within your community, they may be able to serve in that role. In that case, it is appropriate to explain that you are in regular behavioral health care already.

There will likely be complete screenings as a routine part of your care to look at maternal stress/perinatal mental health concerns. They may also be helpful in holding the balance of psychotropic medication/medication choices, while you are pregnant, if that is part of your typical mental health treatment plan. You can consider signing a very specific and narrow release with your therapist, but generally, I would limit it only to things like medication, pregnancy health, dates of service. I would not allow your therapist to release your progress notes, progress summaries, treatment plans unless there is a compelling reason to do so.

The Damage Done

I came of age in the early 1970s. I will admit that I have way too much life history with drug use. In fact, addiction was the primary cause of my first marriage’s failure. So many children are removed from their parents due to addiction issues. The money that should be feeding and housing and providing all the basics for their family goes into drugs. I understand. I remember food and housing insecurity because of that in my first marriage. Today’s blog was triggered by this story of a foster care child.

My 11 year old foster daughter is (understandably) having an incredibly hard time coping with feelings of abandonment by her mother. While I don’t agree with it and have advocated otherwise, she is not allowed to talk to or see her mom until she takes a drug test. Mom has refused and my foster daughter is feeling unloved and abandoned. I’m at a loss for how to help her cope. She often asks me to validate her feelings by saying things such as “If she loved me, she would just go do the drug test, right?” or “She must be on drugs. She loves them more than me, doesn’t she?”. She wants me to answer her yes or no. I don’t know how to answer to help her. I don’t want to speak negative about her parents by agreeing with her but I don’t want to make her feel like her feelings aren’t valid by saying something like “She loves you but drugs are powerful and affecting her choices.” I have reached out to mom and tried to get her to take the drug test so they can have contact and let her know what is going on with her daughter. She always says she is going to but hasn’t yet. It has been over a year now.

She ends with this request for advice – Those who have been through similar situations, how would you recommend I help this child?

The first answers are good ones. Is she in therapy? She needs somewhere to process feelings and learn about addiction. Does she have a therapist? If not, that would be very helpful. Someone who is trauma informed, addiction experience, and foster care and adoption competent would be a good thing for her. Sounds like you and her therapist need to have a discussion about addiction with her.

I didn’t know about this person but it sounds like reasonable advice – I highly recommended listening to and reading Gabor Mate and as an addiction expert and particularly his compassionate, scientifically based approach to addiction. It will help you (and your subsequently foster daughter) understand with compassion rather that judgement, anger, exasperation or frustration.

Personally, I saw this perspective immediately and am glad this was said – Her mom probably can’t pass a test and doesn’t want to make things worse. I would start by explaining that. We wouldn’t make an illiterate person pass a reading test for a basic human right…sad. Being a child of an addict there is a lot of pain and hard days for sure but she should be able to see her mom. All the therapy suggestions are on point and hopefully the therapist can also advocate.

I had not heard of this concept (except from link below) but it also seems right to my own heart – I would advocate for safe use with the social worker on the case about safe use, and creating a safety plan. Passing a urine analysis doesn’t equal safety and not passing a urine analysis doesn’t equal unsafe. I don’t think “she loves you but drugs are powerful….” would invalidate her feelings. That statement and her feelings can both be valid at the same time.

Traditionally, the substance use field has focused simply on substance use and ways to measure, prevent and treat negative consequences. This has led to a continuum of laws, policies and services that runs from restricting supply to reducing demand and, for some, continuing on to harm reduction.

Various versions of this simple continuum have been used over time, all of them beginning with a focus on a disease or harm that must be avoided. While this may seem completely sensible at first glance, it makes less sense when considering that many people use psychoactive substances to promote physical, mental, emotional, social and/or spiritual well-being. In other words, people use substances to promote health, yet substance use services focus on how drug use detracts from health.

Health promotion begins from a fundamentally different focus. Rather than primarily seeking to protect people from disease or harm, it seeks to enable people to increase control over their health whether they are using substances or not.

Since many people use drugs often or in part to promote health and well-being, health promotion along these lines involves helping people manage their substance use in a way that maximizes benefit and minimizes harm. (Indeed, this is how we address other risky behaviors in our everyday lives, including driving and participating in sports.) It means giving attention to the full picture—the substances, the environments in which they are used and in which people live, and the individuals who use those substances and shape the environments.

Someone else shares their personal experience – My kids (adoptees) parents have issues they go through and are not always on the up and up but we make time together happen. It’s always (right now) supervised etc. However soon my daughter will be 16 and she will likely want to drop by their house when she’s driving etc and I have helped her understand enough on ways to stay safe emotionally and legally by going to see her family and having open discussion with her on addiction. Some may not agree but they eventually grow up. I prefer to help her work through it now than stumble more later. She has a therapist who is mainly focused on addictions as well.

One more from personal experience – I would probably say screw the social worker’s orders and let them have a visit. My adopted daughters’ mom had the same type of demand and I followed the rules. Their mom died, and it had been so long since they’d seen her in person. I frequently regret not breaking the rules. Life’s too fucking short and unpredictable. Using drugs doesn’t automatically equate to being unsafe. It’s going to be way harder for this mom to get clean and sober if she’s not allowed to see her child.

Addiction is a VERY complex issue. My heart breaks for the young girl.

Almost Never Acceptable

It’s very hard to understand why ANYONE would choose to take another mom’s (or dad’s) child either through adoption or by becoming a foster caregiver. The only acceptable path I see is true kinship, when their parents are dead, ie they are orphans (both of my parents were adoptees and I thought they were orphans when I was a child – I was totally ignorant that biological family existed and was living lives unknown to me). Other than that, no possible excuse.

So here are some questions for adoptive parents and foster caregivers to contemplate: How do you not see what an absolutely horrible thing this is to do? Have we as humans become so blind that we see taking another mother’s child as a good thing? Where is the accountability for adoptive parents and foster caregivers since they are contributors to this huge problem of family separation? Why are we constantly talking about the best interest of the child and not the best interest of the family? Do adults who lose their children not count as well?

A better choice is guardianship and not adoption – if there are children who have arrived in your home, who aren’t able to be with their first/birth family. Allowing them their identity and knowledge of their genetic family.

One should feel absolutely sick to their stomach, if they’ve built their own ‘motherhood’ on another woman’s brokenness and loss. How cruel and selfish, to be so focused on your infertility loss, that you failed to see the other humans in your family’s picture.

No one advocates kids being abused.

Our society needs to be doing something before a crisis sets in. Maybe the parents need support and some intervention but this should occur WAY before it becomes necessary to remove children from their natural home. Maybe those parents didn’t have a good role model, to show them how to parent properly. Without a role model for how it is done, it can really be an impossible task. Maybe if, as a society, we didn’t leave so many parents unsupported, there would be no need for adoptive parents and foster caregivers.

I know that this sounds very utopian. The challenge is actually translating this into the real world solutions. So how would real world people make a difference for families where the children have been separated from their parents for apparently valid reasons involving the child’s welfare? Here are some ideas related to foster care . . .

The social end goal for that situation is reunification of the children with their parents. There are a lot of steps along the way. Weekly urine analysis requirements, parenting classes, drug counseling, therapy, visits/phone calls with kids, parents needing housing, a job, education, showing up to court.

As a foster parent your job should be to walk along side the parents as an additional support to them in their own efforts. You can’t make anyone do anything, but you can support them, encourage them and remind them of the ultimate goal. You can help pay for those weekly urine analysis requirements, if $10 a week is too much. You can help them get signed up for parenting classes, you can drive them to parenting classes. You can help them find a drug program and get started with therapist. You can provide transportation and support after those sessions. You can go to court and support them and advocate for them. You can help them get to visits, or call them instead of waiting for them to call. You can help by providing resources for housing/jobs. Transportation, if needed.

And then after you’ve helped, you’ve taught them a lot about where to access the resources they need. You’ve shown them what they can do for themselves. And now, they may have many of the skills they need to be successful. You’ve lead them to goal by supporting them and making them feel safe that you aren’t only there to take their children away. Now they can find their own way to parenting their children properly.

And the inconvenient truth is this – too many foster parents flat out refuse to spend any time with the children’s parents or even talk to them because they look down on them as inferior and damaged and not worthy of help. Yes, it is true that some children’s parents are not safe, but it is more true that most of these parents simply need some help to be safe.