On April 8, Julia Steiny, a columnist for the Providence Journal began one of her columns with a lesson from medicine in the 19th Century that has profound implications for child welfare today. Steiny wrote:
“Before understanding the role of germs or microbes in causing disease, hospitals had a well-deserved reputation for killing patients more reliably than curing them. But toward the end of the 19th century, hospitals began to implement sanitary protocols that increasingly prevented the transfer of germs. As a result, hospitals became more effective at healing the sick. Except in the case of children. The rates at which children died actually rose, and dramatically.
“Sick children who went to the most up-to-date hospitals were well-tended - kept fed, warm, safe and clean - and forbidden to see their germ-ridden family. Hospital workers wore gowns, masks and gloves when handling babies and children. Institutions that permitted brief visits by relatives found the visits to be hugely troublesome, brimming with emotions and trauma at each separation. Most hospital officials thought such visits were counterproductive to healing.
“By the second year of a hospital stay, children's death rates in the sterile nurseries ran over 75 percent.”
The column wasn’t about child welfare, however. It soon veered off into a generalized plea to spend more on children and make schools better. (Steiny is a former member of the Providence School Board.) Which means even she missed the point.
In the late 20th Century, as I’ve noted before on this Blog, researchers made a similar discovery about children in the child welfare system.
University of Florida Medical Center researchers studied two groups of infants born with cocaine in their systems. One group was placed in foster care, the other with birth mothers able to care for them. After six months, the babies were tested using all the usual measures of infant development: rolling over, sitting up, reaching out. Consistently, the children placed with their birth mothers did better. For the foster children, being taken from their mothers was more toxic than the cocaine. That doesn’t mean we can simply leave children with addicts – it does mean that drug treatment for the parent is almost always a better first choice than foster care for the child.
In the early 21st Century, Minnesota researchers discovered that, on average, children placed in foster care fared worse than equally maltreated children left in their own homes, even when the birth parents got little or no help.
None of this means that no child ever should be taken from her or his home. (I always think that’s obvious, but almost every time I talk to reporters they seek reassurance on this point). But for decades, Child Protective Services agencies have tried to “sterilize” our children’s environment. They’ve decided that parents are just so “dirty,” sometimes literally, sometimes figuratively, as in so deeply troubled, that the children would simply have to be better off in a “cleaner” environment.
A long time ago, hospitals figured out what they were doing wrong. They stopped keeping the children away from their parents. For some reason, much of American child welfare has yet to get the message.