One evening during the blizzard of 1993, my biological mother surrendered me to the lifelong care of my maternal grandmother. I was 5 years old. She packed a bag, bundled me in layers, and walked me out the front door — instructing me to wait until someone came to pick me up. As an adult, I vividly recall the event and now grasp its reality: My mother was engaged in an insidious crack cocaine addiction. Left to her own devices, this was the best she was capable of doing for me.
Stories like mine were common during the crack epidemic in the 1980s and '90s. News footage showed SWAT teams charging homes, incarcerated parents, soaring drug-related fatalities, children placed in kinship or foster care. Undeniable stigma flooded communities.
Today, amid a fearsome opioid epidemic, history repeats itself as we witness carousels of familiar images: families torn apart, children in crisis.
As a person in long-term recovery who was raised by a grandparent, I deeply empathize with anyone impacted by the disease of addiction.
In my role as director of prevention programs for the state leader in child-abuse prevention, I appreciate the ethical dilemma Pennsylvania Supreme Court justices face in how to intervene with pregnant, substance-abusing women.
Last month, they heard oral arguments in a case involving a woman who gave birth in January 2017 in Williamsport Hospital, about 175 miles northwest of Philadelphia. The mother tested positive for marijuana, opioids, and antianxiety drugs that can heighten the effects of opioids, and her infant spent 19 days at the hospital being treated for drug-withdrawal symptoms. Clinton County Children and Youth Services (CYS) took the baby into custody, accusing the mother of child abuse under Pennsylvania's Child Protective Services Law.
Criminalizing this mother's behavior is not the answer. The threat of arrest and separation will only result in generations of substance-dependent individuals, promotion of stigma, and increased barriers to pre- and post-natal care.
CYS attorney Amanda Browning declared the case to be about "human rights, equal protection, and child welfare." In my view, we can only uphold human rights and foster equal protection if we also include the welfare of the mother in the child-welfare equation.
Children separated from parents face myriad holistic traumas due to interruption of nurture and attachment. These children are more likely to become substance-dependent. If this is the trending outcome, and research proves it's true, can we claim validity in a punitive approach under the rhetoric of "equal protection"?
Research conducted by licensed, trauma-focused therapists indicates that children who can remain with their parents during the treatment and early recovery process have healthier, stronger positive attachment, and significantly lower ACE scores (adverse childhood experiences). Children are significantly less likely to manifest conduct disorder, anxiety, and depression — three conditions that often manifest in substance abuse.
There are few licensed, evidence-based, inpatient programs allowing parents to enter treatment accompanied by children. Women seeking interventions are limited and threatened by the system, and the possibility of losing their child upon admitting they need help. Attached to these barriers is the issue of funding and how they will afford a treatment stay, or if treatment will be interrupted because of insurance terms.
We need a well-informed, cross-systems approach combined with services and interventions delivered through a scope of empathy, compassion, and empowerment. We need public health nurses and master's-level licensed clinicians to serve as advocates in these cases. We know that home visiting nursing programs play an integral role and create strong outcomes for at-risk populations. I urge the justices to consider why these professionals have not been asked to assist in guiding the courts to develop best practice standards for pregnant women with substance-use disorder.
When I ponder that snowy night in my childhood, I also consider my biological mother's fraught decision. My heart aches for her. It's clear to me now that many women in her position do not give up on their children. They give up on themselves. They are filled with fear, and they lose hope.
For the voiceless children born into addiction, and for their mothers, it is my hope that prior to exacting punishment, those in power contribute to a mother-and-child-focused solution.
I challenge my colleagues, my fellow Pennsylvanians, and these justices to be contemplative and compassionate. Always protect the child. Always. In doing so, please remember it is the sum of all actions and all decisions that writes the early pages of a child's story.