Child Protective Services and the American South

Ms. R lives in a rural town in the American South. And like many poor women, especially those living outside metropolitan areas, she had tremendous difficulty accessing appropriate prenatal care.

Ms. R developed an opioid dependence after doctors prescribed her medication to manage the pain associated with an undiagnosed but relentless medical condition. Over time, her medical disorder was diagnosed. She was thrilled to be able to return to work again, and even more thrilled when she found out she was pregnant.

She sought out providers of opioid assisted therapy, the gold standard of care for treating women with opioid dependence. Indeed, detoxing or quitting opioids is not medically advised during pregnancy, because it may result in miscarriage or significant fetal stress.

Unfortunately, and perhaps unsurprisingly, she was not able to find an opioid assisted therapy provider who would accept a pregnant client. A very small percentage of treatment facilities accept pregnant women, despite the recommendation of ever leading health organization that these facilities prioritize treatment of pregnant women. Thus, Ms. R. did what most any mother in her position who was eager to sustain and nurture her pregnancy would do—she continued to use opioids, largely unsupervised, in the hopes of mimicking the effect of medically supervised treatment.

Ms. R. traveled several hours from her house to give birth at a hospital that had a program for babies who are exposed to opioids in utero. Her honest admission to the hospital that she took both licit and illicit opioids throughout her pregnancy set off a child custody case that separated Ms. R from her newborn at birth. In the eight months that have passed, Ms. R. has seen her son once a week at best. The case has been wrapped up in complete misinformation on the nature of opiate use during pregnancy, a steadfast refusal to adhere to the recommendations of expert testimony regarding Ms. R’s opiate use, and procedural snafus. She is prohibited from breastfeeding her son, despite the medical recommendation of every leading public health organization that this is best for both mother and child, especially babies exposed to opioids in utero. Her son has visibly suffered from his separation from his mom.

The requirements of family court judges  -- regular drug testing, mandated counseling, scheduled, supervised visits and having an “open door” for impromptu house inspections to check her living conditions – mean that Ms. R. can’t maintain a job or make a stable home that will satisfy the demands of legal systems in not one, but two states with different policies. Meanwhile, Ms. R. is striving to stay strong in spite of the agony of separation from her son and stress of her case.

Here is Ms. R’s story, in her own words:

“I am the mother of five beautiful children. But I have had my family ruthlessly attacked and broken up by what is known as Child Protective Services (CPS). I am a low-income yet educated single mother from a small town. I have come under the scrutiny of child welfare agencies in both my home state and the neighboring state where I sought medical care.

In 2012, I was under the review of this agency as a result of domestic violence inflicted upon me. Once the floodgates were opened, there was no stopping them. They have used this case against me ever since.

In 2014, I became very ill and was prescribed opiates for medication. When I was finally diagnosed c-diff, I had already become physically dependent. And I got pregnant unexpectedly. 

Worrying about my child, I immediately attempted to take myself off these medications. At the advice of medical professionals, I was placed back on these medications. I was clearly told that detoxing from these medications put myself and my unborn child at risk. 

After contacting more than 60 licensed buprenorphine doctors in the state, I was unable to find anyone who could treat me with the appropriate medications. There were periods during my pregnancy that I used both legal and illegal prescription opiates. During those times, when I was unable to have access to legal medications, I used illegal street opiates. While people may judge me, I knew that going off opiates could harm my child. I did everything that I could in the best interest of my child. 

And I delivered a healthy, beautiful 9-pound baby boy. 

But because my son had been exposed to opiates, I was charged with child neglect. My infant son has been removed from my care since his birth.

I have not been allowed to breastfeed.  I am now only able to see my son for one hour every other week. I attend weekly medication-assisted treatment. I attend weekly counseling and therapy. I have completed all requested parenting classes and assessments.

With little to no knowledge about the legal system, it has become very difficult to defend and fight for my rights to parent my own children. I have gone above and beyond to try to satisfy the family court’s requests. I have been told that my efforts were not completed according to their schedule. I was told that if I signed over my rights to my daughter in one state (the case resulting from the domestic violence situation), I would be allowed to keep my other children. 

I did everything they asked, but in both states, CPS processes were not followed. Before the pregnancy, CPS did not help me find addiction treatment. After the pregnancy, CPS lied about my case repeatedly to the judge. When a leading expert on opioid use and pregnancy testified on my behalf, they were embarrassed at how wrong they were. They doubled down on their efforts to prove themselves right and found things wrong with my life like my housing or employment situation. At one time, after I had cried in my boyfriend’s arms after a visit with our baby son in the parking lot of his daycare, I received a letter from them accusing me of engaging in inappropriate sexual contact. The judge believes almost everything CPS says.

I could write about my story for hours and still not get all of the details out there. I’m hoping that someone understands the value of keeping children with their biological mother. Child Protective Services is supposed to enforce and regulate child abuse and neglect. They should not be removing children from a loving mother based on their personal opinions and lack of expert knowledge. 

In the family court systems, there is no legal process, no respect for medicine or science. The goal seems to be closing a case and often times adoption. This is all done under the cloak of what is in the “best interest” of the child”—but that is ironic, because they are hurting my son. I am hoping that there are individuals who will understand how difficult it is to be separated from your child or newborn. 

Mothers are being penalized for seeking helping for an addiction or domestic violence. Children are being taken away and kept from their mothers due to financial instability. Rather than helping keep families together, CPS and our government would rather remove children and pay strangers large sums of money to care for them. 

Reform is absolutely necessary. I have appealed my case with my daughter. I am fighting for the return of my newborn. I hope that other women do not have to go through what I have gone through. But, unfortunately, I know that I am not alone.