A Childless Motherhood

Well of course! Did we think there would be no consequences? Did we actually think we could get away with it? That there weren’t two sides to the story that we all needed to hear?

Sometimes I think we are so focused on our journey to right a wrong, that we wander off the path to those we hope to save. Things are too partitioned -a modern day rendition of the biblical Matthew 6:3 where the left hand does not know what the right hand is doing… Or, perhaps, is not doing.

If one side of a page seems to contain all the information I seek, I may miss what’s written on the back. I feel no need to turn it over. An article in the Conversation turned the page for me:

https://theconversation.com/losing-children-to-foster-care-endangers-mothers-lives-93618

The author, Elizabeth Wall-Wieler, a PhD student in Community Health Sciences at the University of Manitoba, writes that ‘Mothers whose children are placed in foster care are at much higher risk of dying young, particularly due to avoidable causes like suicide. When a child is placed in foster care, most of the resources are focused on the child, with little to no support for the mothers who are left behind.’

In retrospect, of  course, it seems obvious -the mother-child bond is not something easily missed, and whether or not we attribute it to physiological changes such as oxytocin levels in her blood, or less reductionist, atavistic mechanisms, it is a powerful thing, dismissed only at her -and our– peril.

The author was involved in two large studies, one of them published in the Canadian Journal of Psychiatry, which ‘[…] looked at suicide attempts and suicide completions among mothers whose children were placed in care.

‘In this study, we compared rates of suicide attempts and suicides between 1,872 mothers who had a child placed in care with sisters whose children were not placed in care. We found that the rate of suicide attempts was 2.82 times higher, and the rate of death by suicide was more than four times higher for mothers whose children were not in their custody. […] Mothers whose children are taken into care often have underlying health conditions, such as mental illness and substance use. In both studies, we took pre-existing health conditions into account, so that was not the reason for the higher mortality rates we found.’

And, the author feels, ‘Most legislation pertaining to child protection services indicates that families should be supported, but the guidelines around what is expected of the child welfare system when it comes to the biological mothers are not clear. The main role of social workers is to ensure that the child is doing well. Social workers are already so busy, so it is often hard for them to justify spending their limited time to help mothers resolve challenges and work with them to address their mental and physical health needs.’

Other studies have also addressed the issue of sending children to foster care: ‘A study in Sweden found that by age 18, more than 16 per cent of children who had been in foster care had lost at least one parent (compared to three per cent of children who had not been in foster care). By age 25, one in four former foster children had lost at least one parent (compared to one in 14 in the general population). This means that many children in foster care don’t get the chance to be reunited with their families.’

I thought that the whole idea of fostering a child was care and sustenance until a more permanent placement was achieved or, ideally, the birthparent was able to reassume custody. This is perhaps more likely if the child can be placed with members of the same family -grandmothers, aunts, etc.- but even then, if the mother does not receive adequate support and treatment for the condition that led to the apprehension of her child, the results are apt to be the same.

In Canada, it seems, the mothers most affected are those from the indigenous community -our First Nations. The Canadian Minister of Indigenous Services, Jane Philpott, addressed indigenous leaders about this issue at a two-day emergency meeting on Indigenous Child and Family Services in Ottawa in January, 2018. http://www.cbc.ca/radio/thecurrent/a-special-edition-of-the-current-for-january-25-2018-1.4503172/we-must-disrupt-the-foster-care-system-and-remove-perverse-incentives-says-minister-jane-philpott-1.4503253 ‘The care system is riddled with “perverse incentives”. Children are being apprehended for reasons ranging from poverty to the health and addiction issues faced by their parents. In some provinces, rules around housing mean that your children can be taken away if you don’t have enough windows. “Right now dollars flow into the child welfare system according to the number of kids that are apprehended.” […] If financial incentives were based on “how many children we were able to keep in homes, how well we were able to support families — then in fact there would be no financial reason why the numbers would escalate.”’

But it’s not too difficult to read something else into all of this, of course. Uncondoned behaviour -behaviour frequently associated with poverty or marginalization- is often penalized isn’t it? Sometimes it is as simple as avoiding the transgressing community, further marginalizing it, but increasingly it is intolerance. Refusal to address the underlying issues. Not even trying to understand.

I admit that it is a difficult journey, and the road that winds between the abused child and its troubled parent is fraught. To empathize with the mother when her conduct may have been so clearly unacceptable, is seen as anathema. And yet, an attempt to understand is not a plea for condonation, merely a search for a solution. Nobody should get away with family neglect -but nothing happens in a vacuum. And there are always unintended consequences, aren’t there? Even our best intentions miss something in retrospect -solve one problem, create another. Our focus is often far too narrow -helping one person misses the one standing beside her.

Perhaps it’s time for us to stand back. As Ms Wall-Wieler puts it, ‘Specific guidelines need to be put in place to make sure that mothers are supported when their child is taken into care. This would improve the chances of reunification. And, by virtue of being a human worthy of treatment with dignity, mothers deserve support, even if it does not directly relate to how she interacts with her child(ren).’

‘Of the good in you I can speak, but not of the evil.
For what is evil but good tortured by its own hunger and thirst?’
Kahlil Gibran

 

 

 

 

 

 

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Crybabying

I remember (sort of) my days in Elementary School, when one of the most devastating insults a little boy could receive was to be labelled a crybaby. I’m not sure why, really. Maybe it meant you didn’t fit in with the prevailing umwelt –with what you were supposed to be as a little boy- or maybe it was just a talisman raised to guard against the fear that despite its undesirability, it might be hiding in us all –even the accuser. Children are inherently superstitious, don’t you think?

It never occurred to me to wonder about the expression at the time, nor even later when I had children of my own. Babies cry, often too much, and perhaps more to the point, often at inconvenient times: during the nights. But I never suspected that it was sufficiently upsetting that it would transmute into folklore as a children’s curse. In fact, as childhood made way for my adult clothes, I didn’t think much about it at all -let alone as an imprecation- until I happened upon an article in the CBC News: http://www.cbc.ca/news/health/babies-crying-health-study-warwick-university-1.4052932 ‘Researchers at the University of Warwick conducted a meta-analysis of studies involving about 8,700 infants in countries including Canada, Germany, Denmark, Japan, Italy and the U.K.’ and guess what? ‘[…]babies in Canada, Britain, Italy and the Netherlands cry more than babies in other countries.’ And not only that, ‘On average, Canadian babies cried 30 minutes more than babies from other countries.’ Great! There goes our long held patriotic claim to be the ‘polite nation’ -the one usually definable by what we are not: (not American, not greedy, not pushy, not… Well, you get the point). ‘Canadian babies had some of the highest levels (peaking at three to four weeks at 34.1 per cent of infants), followed by the U.K. (peaking at one to two weeks at 28 per cent) and Italy (peaking at eight to nine weeks at 20.9 per cent).’ ‘Germany, Japan and Denmark had the least amount of crying and fussing babies.’ Damn.

Mind you, if you actually look at the article reported by the CBC:  http://www.jpeds.com/article/S0022-3476(17)30218-4/fulltext – s0070, ‘Overall, fuss/cry durations were high across the first 6 weeks of life, then reduced significantly over the following 6 weeks. All studies found a “universal” reduction in fuss/cry duration between 6 and 12 weeks of age.’ The reasons for the differences were not at all clear: ‘[…] we can only speculate on the reasons why there are country differences, in particular between Denmark and the rest of Europe and North America. These could range from economic conditions, such as less social inequality, to caretaking patterns such as responsiveness, carrying behavior and management in Denmark that have been shown to differ from the United Kingdom. However, there may also be population genetic differences, and the infants both inherit their parents’ genes and are reared by them (gene-environment correlation). […]Feeding type was a further moderator of fuss/cry duration. Bottle or mixed feeding was associated with reduced duration of fussing and crying or colic from 3-4 weeks of age onward. Switch in feeding type is one frequently adopted method by parents dealing with a crying baby and has been found to reduce crying regardless of what formula change is instituted, suggesting a placebo effect.’

Unfortunately, ‘[…]this is a review of studies in North America and parts of Europe with only 1 study from Japan. No studies from threshold or developing countries were available, but these would be needed to provide adequate feedback to parents on other continents. Feeding type information was also not available for some studies.’

And what about ‘colic’ the catch-all word for persistent crying? ‘The most widely used definition for colic is the “Rule of Three’s”: an infant is considered to have colic if the infant fusses or cries for >3 hours, >3 days per week, for >3 weeks.’ Unfortunately it is, apparently, often a diagnosis of despair with no readily identifiable cause. Indeed, ‘The rapid developmental change in fuss/cry duration has implications for treatment and interpretation of treatment studies. Colic is the extreme of normal fuss/cry behavior, self-limiting, and, thus, the vast majority will spontaneously remit. Adequate management of fussing and crying in the first 3 months rather than treatment may be required. However, if excessive fuss/cry persists beyond the first 3 months, there is increasing evidence that this may indicate regulatory problems with adverse consequences for future development and may require treatment.’

But, bringing it back to Canada, my terre natale, ‘Psychology professor Dieter Wolke, lead author of the study, says Canadian parents need not worry. […] He pointed out that babies in Canada peaked around the three-four week mark but fell into a more normal range around week six.’ …Damned by faint praise again…

And what about Germany, Japan and Denmark? Especially Denmark –why does it always seem to win everything? ‘”In Denmark, it seems to be they’re more relaxed about it,” Wolke said. “They might have a little bit more support because of maternity and paternity laws … the father in the first few weeks can stay at home, too.” It’s worth noting that Denmark regularly falls at or near the top of the “best countries to live in” lists. Wolke speculates that this may foster a population that feels good about itself, and those emotions can transfer to the baby.’

Uhmm, excuse me! ‘”Babies are already very different in how much they cry in the first weeks of life,” the researchers said. “There are large but normal variations”’. So let’s not dump on les petits Canadiens, eh? It’s a squeaky wheel that gets the grease, after all. Right? …I mean that’s right isn’t it…?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Bicameral Mind

Time to unwrap the Jeremiad again, I’m afraid; I’m getting tired of this. Really tired. I know it’s an American thing, but stop it will you? Or can you? Every time there’s a bicameral shift it tears the fabric a little more and unravels what I want to believe about your country. Yes, I’m Canadian and watching with unvetted eyes I guess, and yet sometimes it is good to hear from the other side of the mirror. To listen to the indrawn breath and pause to look around. Sometimes acumen travels in disguise: the dusty traveller leaning on the fence, the unwashed face of Vishnu. Wisdom does not always wear a flag.

One of the things I’m referring to, of course, is the perpetually probationary status in the United States of both family planning and pregnancy termination. Women’s rights seem contingent upon the prevailing ideology, their status as stable as the government in power -guaranteed only conditionally, and as changeable as the pen that underwrites them.

As a non-combatant, I suppose I should only listen with firmly closed lips; perhaps the border should be a closed curtain so I cannot see through. And maybe I should apologize for being so critical, but when is this vacillation going to stop? I accept that there are valid differences of opinion, and that any decision is inevitably temporally adjudicated. Times change, and so do populations and their ethnic and cultural compositions. It’s happening to us all. But surely the answer isn’t to retreat behind the doors and barricade the walls.

And defunding organizations that seek to address the issues of involuntary overpopulation would seem unduly parochial and even internationally misunderstood. It is the special duty of an enlightened nation to accept that there are many roads and many destinations. It has, it seems to me, the burden of reasonable neutrality, grounded observation, and judicious guidance.

The issue, I think, should be one of choice not fiat. Conscience, not doctrine. To offer alternatives is not to coerce, nor to prejudice the selection; it is surely to achieve the goal for which the options were offered in the first place. Not all things are equally acceptable; not all choices are politically or culturally permissible, to be sure. So a variety of solutions might have a greater likelihood of admissibility. A greater possibility of success.

Several years ago, I travelled to the States to attend a gynaecological convention and discovered that not only was pregnancy termination still an inflammable topic for many delegates, but even the provision of Family Planning counselling for whoever requested it. I found this hard to understand, especially at a meeting of specialists in the field.

I remember questioning one of the doctors I met there and she rolled her eyes at my Canadian naïveté. “Do you remember that fable of Aesop called ‘the Belly and the Members’?” Now I felt really naïve because I had to shake my head.

She seemed surprised. “Well,” she said, after interrogating my face for a moment to make sure I wasn’t kidding her. “The version my daddy told me when I was young went something like this. One day, after carrying the body through a long day of heavy work, the feet complained that they seemed to be the only ones in the body who had to work. Of course the hands argued with them that they were the ones who should complain -the feet may have carried the body, but they had to carry and even balance the load. The only thing they could agree on, after a long argument, was that although the four of them worked all day, in the end it was the stomach who got all the food.

“So, they devised a plan. The feet refused to walk to the stove, and the hands refused to pick up any food.”  The doctor smiled at this point and pierced me with her eyes. “And you can guess what happened after a while… They all got weak and finally had to agree to work together. Only the stomach could give them the strength they needed.”

She giggled at the end and touched my arm playfully. “I can’t believe you didn’t know that one, doctor.”

I hate it when a colleague calls me ‘doctor’, but I let it pass. “And I take it the fable is telling us that we all have to work together, no matter that we’re different? And that we can all have different opinions?”

Her expression changed and a puzzled look crept onto her face. “Never thought of that, actually… My daddy said it meant that we all have our jobs, but need someone –something- watching over us to give us strength and direction… Reminding us of what we should do. He said the Stomach was our Conscience… But I think he really meant the President… Or maybe the Lord…” She shook her head in apparent disbelief at my interpretation. I blinked, because it didn’t make sense to me. I wondered if she’d remembered it wrong.

“You must have similar fables even up there in Canada…” I could tell she was trying to understand my confusion. Transcend boundaries.

“Well,” I started, just like she had, “I do remember one about chopsticks…” She smiled at my multiracial example –so Canadian. “It was something one of my Chinese patients told me after giving me a little gift for delivering her baby. She said her father had told her this when she was a child.

“’There was an old man,’ she said, ‘who was close to death, and worried about what would happen after he died. He decided to ask the wise village elder if he knew what it would be like in Hell. The elder smiled and told him to imagine a large room filled with people. ‘They are all thin and hungry,’ he said ‘even though there is food everywhere.’

“’Then why are they so thin,’ the old man asked?

“’Because their chopsticks are each ten feet long,’ was the answer.

“The old man thought about it for a minute. ‘And Heaven,’ he asked, ‘What’s it like in Heaven, then?’

“The elder laughed. ‘Imagine another large room. There is food everywhere, but the people are fat and happy in spite of their ten foot long chopsticks…’

“The old man was puzzled. ‘But… I don’t understand.’

“The elder smiled and put his arm around the old man. ‘In Heaven, they feed each other…’”

Perhaps, I thought, after watching my colleague’s reaction, perhaps there is something more profoundly different about our two countries than simply the colour of our mailboxes…

Prostitution Laws

Okay, I think you’re going to have to help me with this one. Suppose you have a product the courts have decided you are legally entitled to sell, but a new law is enacted making it both illegal to advertise or purchase it… Am I missing something here?

In December 2013, the Supreme Court of Canada, in a unanimous 9-0 ruling, struck down Canada’s prostitution laws as violating the Constitution guaranteeing Life, Liberty, and Security of Person. The law it disallowed had prohibited brothels, street solicitations, and living off any money derived from prostitution. The government was given a year to come up with a new law.

http://www.huffingtonpost.ca/2013/12/20/supreme-court-prostitution-canada_n_4478127.html   

So, six months later in early June, they did just that, closely following the so-called Nordic model: selling sex is legal; paying for it is not There are a few subtle Canadian twitches to this model (of course), but it pretty well boils down to the the same result. Which brings me to the issue with which I need some help.

The problem that the government is trying to solve -apart from what they perceive to be the moral one- is the crime that often accompanies prostitution: drugs, violence, and the nuisance to the community where it occurs. And when pressed, they seem to subscribe to the views of Gunilla Ekberg, a lawyer in Sweden who played a role in that country’s adoption of the Nordic Model in 1999. She described prostitution as a form of male sexual violence and has said that the law focuses “on the root cause, the recognition that without men’s demand for and use of women and girls for sexual exploitation, the global prostitution industry would not be able to flourish and expand.

The problem with that argument, of course, is that it doesn’t get rid of prostitution; it merely drives it further underground unsupervised, and into dark and unsafe alleys. It is an approach that, to be polite, is naive, and dangerous for prostitutes -who, remember, are legally recognized as such. And as citizens living within the law, they are entitled to its protection. That, I think, was the intent of the Supreme Court’s decision.

There are various models in other countries that have also attempted to deal with the issues surrounding prostitution. None is perfect, but some appear to offer more protection than the one proposed as a reaction to the Supreme Court. The New Zealand approach seems popular with sex workers in Canada:(http://www.huffingtonpost.ca/2014/06/05/sex-workers-like-new-zeal_n_5450692.html)

And as the linked article states: Prostitution, including brothel ownership and pimping, has been legal in New Zealand since 2003. The sex industry operates under employment and public health laws. Prostitution that is not consensual or involves someone under 18 years is illegal. It’s also against the law to compel or induce someone into sex work, or to provide their earnings. Larger operations must be certified. Prostitutes are still vulnerable if they work on the streets, of course, but the brothels at least allow better working conditions and protection.

It seems to me that offering safe working conditions for a service between two consenting adults goes a long way towards the intent of our constitutional protection. To ascribe denigrating moral attributes to a consensual act ignores the overriding necessity of security of person. To fly in the face not only of the intent of the Constitution but also the ruling of the Supreme Court of Canada which acted to defend it, merely to punish those who, in your opinion deserve it, strikes me as arrogant in the extreme. Intolerant. It smacks of a fundamentalist omniscience, a disinclination even to attempt to view society through the lens of those with whom you disagree.   http://www.huffingtonpost.ca/daniel-tencer/prostitution-law-canada_b_5451466.html 

I hasten to add that I know we all have strong beliefs surrounding this issue -myself included- and I understand the disparate feelings the ruling seems to have unleashed. I also recognize that there is likely no solution that can satisfy everybody. Debate about it is not only appropriate, it is necessary. But to debate, one needs to hear both sides of the argument. The merits and problems with each and every viewpoint need to be explored. There should be no monopoly on interpretation. No unilateral power politics. It is not the prerogative of any elected government to legislate morals at the expense of constitutionally guaranteed rights.

Personally, I object to any government assuming it knows what we should and must believe. And I object to a government that is so convinced that prostitutes are on the wrong track, it thinks it should commit $20 million for a program to encourage them to change their ways. Not all the electorate subscribes to this evangelistic approach:

I’m reminded of a quotation from Oscar Wilde: Morality is simply the attitude we adopt towards people we personally dislike. Is that what’s going on here? The government says it’s not… so it can’t be. Right?