Your BIRTH Partners
Your BIRTH Partners
Impact of Family Policing System on Community #077
We are diving into another heavy and intense conversation here, as we talk about the family policing system, sometimes also referred to as the child protective system.
We are confronting what it means for us, as healthcare workers, as birth workers, to be tied up in this system that is involved in family separation, and ultimately, the policing of families.
When I was thinking through all of the different angles to take throughout the season, as we figure out what it means to be in community, with each other with those we serve one of the pieces that just kept coming back to me is how disconnected our care, especially in the hospital, can be from the greater community that we prepared to serve. And I think one of the big ways that that shows up is in how we interact with folks who use drugs, with folks that have mental health disorders, with folks who in so many ways, are othered, they don't meet our kind of expectation about "textbook perfect parent." We are thinking a lot about how that plays out in our role as mandated reporters, how we engage with these systems.
I am so grateful to have Carlyn Mast back on the podcast. Carlyn is an exceptional advocate a repeat guest on the podcast, who as a social worker, and parent advocate has a lot of information to share that it gives light to really some of what what goes on when we report folks, the family policing system, and how this impacts families, how it impacts communities, and really the role that we have within this as perinatal care professionals.
So this episode is for those of us who are not really familiar with the child protective or family policing system, how it came to be, and how it currently operates. Carlyn is going to share some of the actual steps that we can all take as we continue to interact with families so that we can show up as a community advocate with them.
Join us to dive into:
~Language: Family Policing System
~History of Taking Children from their Community
~Legislation that Criminalizes Poverty
~Racial Discrimination in the System
~Abolition of Incentivizing Family Separation
~Steps to Support Families
Connect more with Carlyn here.
*The statements from Carlyn Mast are her sole opinion and experience, not the opinions or views of her employer.
Resources:
Dorothy Roberts and her book Torn Apart
Joyce Macmillan
April Lee
Movement for Family Power
upEND Movement
Maggie, RNC-OB 0:03
Welcome to your birth partners, the podcast identifying gaps, acknowledging biases, and co-creating a trauma informed standard of birth care with change agents across the spectrum of birth work. I'm your host, Maggie Runyon. I'm a birth nurse, educator and advocate who has been searching since 2010. The answers to how to provide better care during pregnancy, birth and postpartum. Through my own pregnancies and supporting births in home and hospitals around the country. I've seen firsthand many the systemic flaws that exist in perinatal care. Through these conversations, I'm thrilled to share with you insights and inspiration as we work collectively to transform birth care.
Well, welcome back to the show, we are diving into another heavy and intense conversation here, as we talk about the family policing system, sometimes also referred to as the child protective system. And think about what it means for us, as healthcare workers, as birth workers, to be tied up in this system that is involved in family separation, and ultimately, the policing of families. When I was thinking through all of the different angles to take throughout the season, as we figure out what it means to be in community, with each other with those Serb one of the pieces that just kept coming back to me is how disconnected our care, especially in the hospital, can be from the greater community that we prepared to serve. And I think one of the big ways that that shows up is in how we interact with folks who use drugs, with folks that have mental health disorders, with folks who in so many ways, are othered, they don't meet our kind of expectation about quote unquote, textbook perfect parent. And you know, thinking a lot about how that plays out in our role as mandated reporters, how we engage with these systems. And I am so grateful to have Carlyn Mast back on the podcast. Carlyn is an exceptional advocate a repeat guest on the podcast, who as a social worker, and parent advocate has a lot of information to share that it gives light to really some of what what goes on when we report folks, the family policing system, and how this impacts families, how it impacts communities, and really the role that we have within this as perinatal care professionals. So this episode is for those of us who are not really familiar with the child protective or family policing system, how it came to be, and how it currently operates. And what that looks like Carlyn is going to share some of the actual steps that we can all take as we continue to interact with families so that we can show up as a community advocate with them onto the show.
Oh, well, Carlyn, welcome back to the show. It is always just such a pleasure to spend time with you. And I am really grateful for you to come in and dive into another really important topic when we think about what it means to show up and be in community with those that we care for. So if you want to just give our audience a little bit of background about kind of yourself and how you came into the perinatal space.
Carlyn, LCSW 3:17
Sure. So thanks for having me. I'm really happy to be back here. I always love talking with you. So yeah, my name is Carlyn. I am currently a social work supervisor at the Maryland Office of the Public Defender in the parent defense unit. So I work with other social workers that are in the department, I also have a caseload at the public defender's office, specifically the parent defense, we offer holistic legal representation for parents that have been a victim of the family policing system. So parents that have gotten their kids taken away by Child Protective Services, we represent them in court, a social worker, and you know, an attorney, attorney does the court part obviously. But we work together to provide folks, you know, a full holistic, person centered approach to legal defense.
Maggie, RNC-OB 4:10
Yeah, such a powerful role that you have there. And, and one that is not always represented with throughout the system. So I'm really grateful that families in Maryland have that. Maybe just to kind of set the stage for us a little bit as we dive into this topic and kind of go through some of this language we just heard you say, Child Protective Services and family policing system. If you could give us a bit of a historical overview about all the things that are at play as we consider what happens when when we have like a mandated reporter makes a report and it goes into this system. What led us to this point, what happens from there, I think that would be helpful context as we dive into how we can all be part of making changes.
Carlyn, LCSW 4:46
Sure. So I'm first going to start with the language piece. So in my area, and for many folks that are kind of tuned in to the family policing system. We don't use the term Child Protective Services. We don't use the term child welfare, because at its core, this system is plain and simple, not concerned with the well being of children. And it's not concerned with holding those who perpetrate harm against kids accountable. We use the term family policing system, because that is it is what it is Dorothy Roberts, the brilliant and kind Dorothy Roberts coined this term many years ago. Because it is the perfect name for this system. It I think, the family policing system has brilliant marketing, because the average everyday person, the average healthcare worker, does not really quite understand the history of this. And the role of harm that it has caused many families and many children, and that's no fault of their own. This is a history that's not often taught. And it takes a bit of research and dedication to learn it. And most folks don't have that lens, understandably. So, talking a little bit about the history of the family policing system. I think what it's most important for your listeners to understand and work away from is that this is a system that is designed by design to harm families and harmed children. The family policing system dates back to slavery with the idea that children were products of the state, not their parents. So if we think about slavery, families were weaponized by people that own slaves to essentially, you know, hold power over them to discourage revolt to, you know, hold power and oppress. So slave owners would use children of enslaved people to do just that, to make them work to quell any sort of rebellion, they weaponize the bond between a parent and its child to hold this sort of power over them. You know, history has shown us children and parents on slave blocks being separated and being sold. But I think it's important to understand that that children is a, a ward of the state thinks back to slavery. And there have been many other examples of how the family policing system has come to be through history outside of slavery, we see things like the Orphan Trains, and the Indian boarding schools or the indigenous boarding schools. So the the orphan train was a movement that happened. And it was really one of the first kind of publicized social welfare programs. But essentially what it was was in the northeast and urban populated areas back in the 18th, and early 19th centuries, wealthy to do largely white people would go into homes of immigrants of economically vulnerable immigrants, working class immigrants, they stole children, because they did not necessarily agree or approve of the way that the children were being cared for by their parents, their parents were not doing anything wrong. It was just, you know, different cultures, the product of poverty, those kinds of things. These were loved children, they were not orphans, they were loving members of a family. But these like, do gooders stole the children, put them on trains, shipped them out, I believe, mostly to the Midwest, to work in camps, and to be, quote, assimilated into American culture. We also see that with the indigenous boarding schools, that is an incredibly violent history. And I would encourage folks that are listening, if they're not really familiar with that history to read about it, because it is a very stark example of the harm of the system. But you know, indigenous children were stolen from their parents and their tribes, their loving communities, they were shipped to these, what we call it the time boarding schools, which were essentially, you know, these places where they were, their culture was beaten out of them. And there is a famous quote by one of the creators of this system that says, point blank, kill the Indian save the man. And that was the sort of mindset that these boarding schools had, and yeah, yeah, it was it was absolutely disgusting. But it's one of the earliest examples of how this child Child Welfare family policing system works. And it's a great example of the structural violence that it imposes on communities.
Maggie, RNC-OB 9:30
Oh, yeah. Yeah. I mean, thank you for walking us through that, because I think it is important to understand the context that this occurs in. And like you said earlier, I think there has been an incredible marketing campaign around this system. And I think most of us speaking for myself. I was not educated, obviously, on any of this through nursing school. I didn't receive education on this as I took as I've taken how many mandated reporter trainings over the last 15 years.
Carlyn, LCSW 9:56
We can talk about that. We will talk about that and what I just gave you as kind of like the historical origins of this system, but it very much has evolved over time and, and continue to be extremely violent, but it is taken shape because largely federal legislation, I think it's important to know the kind of key parts of modern day federal legislation that have shaped the way that we learn about family policing, the way we think about child safety and what our role as mandated reporters are in this field, we can't have that conversation without understanding the reason that we are here. And I think it's, I have to say this, I am a staunch abolitionist of this system, I think we need to completely dismantle this system, I don't think it can be reformed. And you will see why there have been reforms that have have happened, and they are continuously violent. It's not a system that can exist. And I'm hoping by the end of this, your listeners understand what it means to be an abolitionist, and they walk away and kind of meditating on that. So aside from the historical roots in slavery in the indigenous boarding schools and the Orphan Train movement, the family policing system is what it is today, because of essentially two massive pieces of federal legislation. The first is what we call CAPTA. It's the Child Abuse Prevention and Treatment Act. So that's a federal legislation that was created in the late 80s. It's amended every couple of years to add requirements. And the big thing about CAPTA is it requires states to be in compliance to receive federal funding to support programs. So this federal legislation is tied to block grants, and your state gets the money from these block grants, as long as they are in compliance with this federal legislation. So it's very tricky, you essentially can't get out of it. So this legislation is amended every couple of years. And in 2003, it was amended, and it required states to enact what we now recognize as mandated reporting laws. So a mandated reporting law, essentially, and you know, in the state of Maryland is any suspected abuse or neglect, under the age of 18, must be reported. And how that ties into what we do. And birth work is a positive test at delivery. For an illicit, or at this point prescribed substance. It's mandated by law that that is reported to the family policing system. It is considered the legalese of these can change depending on this state. But it is considered I believe, it falls under neglect at this point. And again, that's something that is changing in certain states. And that is highly concerning and problematic. What CAPTA doesn't do is it doesn't legislate how or when we test, but it does say if a positive test at delivery is present, you must report it. So this was a direct reaction to the war on drugs and the criminalization of people who use drugs and become pregnant. And we know from history that this is largely targets and police's Black women and Black families and families of color. So I also want to take a minute to have an aside. So when we think of reports to the family policing system, and when we think of what is presented as a system of care, right, we have kind of two major areas. We have child abuse, and we have child neglect. I think it's really important for listeners to understand that the overwhelming majority of reports to Child Protective Services, the family policing system are for neglect and neglect is unequivocably the criminalization of poverty. Yeah, yeah, it just, it is what it is. So
Maggie, RNC-OB 10:38
I think that's such an important distinction, because I think most of us, myself included, were more worried I think about abuse, right? We're worried about kids who are in unsafe situations with those in their home, right, who had physical sexual emotion, any, any form of abuse. And so it's interesting and important to note that that is not what the vast majority of these cases actually are, are investigating. Right. So they're looking into, into neglect, which I think for most of us, whether we, ourselves have experienced times of having less economic means, or we have, you know, loved ones who have, like, that's a huge difference. I don't think that's known by most of us, right. I don't think that is what is publicized, or what seems to make headlines around what the family policing system does.
Carlyn, LCSW 14:53
Absolutely. And that's something that as an abolitionist, and we'll talk about this in a little bit, but we are often met with Question. Well, what about the people that abused kids? And that's a really complex and nuanced question, right? Because it is inevitable that some kids in our culture will be harmed. But to that question, I always I reflected back with the evidence, right. So it's not about helping children that that may be the victims of violence or abuse, this is the system you have to move from the framework of, we're taking care of children that are used to this is a system that does not prioritize that and the well being of the children involved in the system, I can tell you, as somebody that shows up to court and hears the arguments in court, they do not care about the well being of children. So in 2019, alone, the family policing system investigated 3.5 million children in the United States. And of those calls, the vast majority were for, quote, unquote, neglect, which as I said, is the criminalization of poverty. In 2016, only 16% of children who entered into care were there as a result of what the department calls substantiated physical or sexual abuse. And I think what's important to note is that the other 84% of children that entered into some sort of state surveillance, whether that is, you know, caseworkers knocking on your door at 2am to check on your child or being put into the foster care system, 84% of them were there for essentially being poor, being born into poverty being born into the working class. And I think that's something that we need to reckon with. And it's often hard for people to reckon with this idea, right? Ideally, in a society, you wouldn't have children not having their needs met, or being in a position where they are being physically abused or assaulted. That's not what we want. But we have to reflect back on our culture. And we have to understand that, that while it's not ideal, and I'm not, I'm not saying that we should ever settle for that this system that we have in place is not the answer to fix it. And that's where being an abolitionist, that's where keeping transformative justice and mutual aid and holding space for the power of communities. That's where this comes in. Yeah, and I guess birth workers, we play a key role in that.
Maggie, RNC-OB 17:30
Oh, my gosh, yeah, absolutely. I'm just thinking through like how, you know, obviously, for those of them, we've talked at length about this on the podcast, there is those threads of Savior ship that run through a lot of caring professions, right. So certainly nursing, I imagine the same for social work within a lot of healthcare, that idea of like saving someone saving the children, polls, at some inner part of us, right.
Carlyn, LCSW 17:56
And we are not going to do that in our current model of care. So I think it's also it cannot be overstated. The racial dynamics of this system and the what Dorothy Roberts calls benevolent terror that this system has on Black families in this country, indigenous families in this country, families of color. Yeah, by the time in this in this country, in Black communities, Black children fit over 50% of Black children will have had some sort of contact with the family policing system by the time they're 18. That's absurd. That's absurd. But it's something that white families, people in position of power, whether that's a health care provider, being a member of a wealthier elite community, that's something that is not even on our radar. But there is an entire, there are two countries and in this other country, in the Black community, over half of families will have had some sort of state surveillance. And I think we just have to reckon with that. It's dying. Yeah, this
Maggie, RNC-OB 19:08
is ridiculous and should not be that way. But it absolutely matches everything else in the way that our country has, in the structural racism, the systemic racism that is embedded in the way our country operates. And like you said, dating all the way back to slavery like that, that thread continues throughout it, and I think it is, I know in reading Dorothy Roberts book torn apart, which I cannot recommend highly enough to anyone who's listening to this conversation who is wanting to really like dive way more deeply than we can in this podcast episode.
Carlyn, LCSW 19:38
She's the scholar in our field. She is an incredible person and just an asset to us as a society as a whole. And I think I what I want to add to this very quickly, but again, it cannot be overstated. Black parents, Black children, do not experience abuse any more any less. than white children, Black parents are loving caregivers, they are not inherently more likely to perpetrate abuse or neglect. This is a result of a racist system and a system rooted in white supremacy, violence, neglect, abuse, whatever you want to call, it happens just as much in white families, if not more, but they are not held to the same standard. They're not forced into this system of surveillance like black families are. And it cannot be overstated. Right? Yeah, absolutely. So we just talked about CAPTA, which, you know, was amended to be this very punitive, non evidence based piece of legislation that was a direct kind of result of our country's war on drugs. This is why I cannot stress it enough. CAPTA is the reason you are a mandated reporter, you're an arm of this state. So the next piece of legislation that is, I mean, it would bring you to tears if you really read about this and what it does to families, but it's the Adoption and Safe family act. It was signed into law in 1997. It was championed by Hillary and Bill Clinton. And it really solidified and encouraged this culture of family surveillance by providing direct financial payments to states based on the number of adoptions they could complete. So this law, one of the most violent parts of this law is that it requires that states move towards what we call TPR, or termination of parental rights, if a child has been in foster care for 15 out of the last 22 months, so unpacking that, right, a termination of parental rights is what we consider the civil death penalty. You are legally your ties are severed from your child, I think it is quite possibly the cruelest thing that you could do to a person and a community. But the direct financial incentives that this law requires that states are paid is to me like what is the grossest part about this? Money is not provided for the number of reunifications or closed cases where you know, baby or child goes back to parent, there is no instant financial incentive for that we are literally incentivizing tearing families apart. And it has created a culture in the courts, that is absurd and violent and benevolent. If you think about 22 months, right? If you think about what can happen in 22 months, to take and sever a bond between a parent and a child based on the actions and 15 of those 22 months, it is, I mean, I like can't even wrap my head around that. But it has catapulted this culture of severing families, which is a sever of a community, when you are put into foster care, you are raised without an identity, you don't know where you come from, you don't have the ties to your family and the routine of your family and the love of that. It is how you sever communities, and it's how you break people. And to think that we are incentivizing that with Direct Payments is just disgusting.
Maggie, RNC-OB 23:29
Yes, absolutely. I guess on the one hand, it's not surprising that these laws exist, right? Because we recognize how troubled the system is. But gosh, it's still just like I did not know about this law till we were having this conversation. It is mind boggling truly, that we only incentivize having children, taken away from their families, that we only incentivize terminating parental rights. There is nothing about that, that makes sense that like there is nothing about that. That is Yeah, is justifiable. And on a personal level, there is that sense of like, responsibility for all of us out here listening who are mandated reporters who have been a part of directly starting this process. Absolutely. That I also think I am currently grappling with as we dive into all this.
Carlyn, LCSW 24:31
Absolutely. And we'll talk about that this is the harm is perpetrated by us but we can also be part of the solution. There is a way forward there is a way to repair and at least try to stop this from happening in the future. The last thing I want to say on like the historical legislation and of this is, you know, as an abolitionist as somebody that supports parents in this we are often met with this idea of like, okay, well what about like I said, What about the kids that are abused, they can't stand at home, you put them into foster care. And I'm not gonna go into my spiel on foster care foster care providers, but it is not a panacea. It is an extremely violent system. And it's one that you are more likely to be abused in. So yeah, I want listeners to take away from this podcast, if anything, again, this system doesn't prioritize the well being of children. It doesn't hold people who abused children accountable. And children who stay with their family, even in cases of like significant poverty, do significantly better in almost every aspect of life than kids who enter foster care. And I just can't overstate it enough, foster care is fundamentally violent. So I'm just going to present you with a quick quote from Richard Wexler, who is amazing, you can read up on him, but he's really a force to hold the family police accountable for the harm it causes. He does incredible work with the National Coalition for Child Protection reform. So in a study of recorded abuse in Baltimore, right, they found the rate of substantiated cases of sexual abuse in foster care more than four times that of the rate of kids in the general population, you know, or kids with their families. So using this same methodology, and Indiana's study found three times more sexual abuse or physical abuse, and twice the rates of sexual abuse in foster homes than in the general population. In group homes, there was more than 10 times the rate of physical abuse and more than 28 times the rate of sexual abuse, as in the general population. And that was in part because children in your homes can abuse each other. So you know, those studies really only deal with reported maltreatment, but you have to understand that the statistics that we are given are the statistics that the family policing system gives us. So, you know, read between the lines, it's not transparent. So the actual amount of physical or sexual violence in foster care is likely to be far higher. And anecdotally, my experience working in this, this space supports that we often see parents having their children stolen from them and come back and say, Look, my kid is with this foster care provider. XYZ is going on. So when we think about this system that is supposed to protect children, and we look deeper, it doesn't, it hurts them. So I just have to, I can't understate that right now. But going back, so I want to try to bridge the gap between all of this knowledge that we know this historical knowledge that we know and what we can do modern day present day, as health care providers as birth workers, the first thing that we can do is use our power to advocate. So we know what keeps people safe, right? We know what keeps kids happy and healthy, and it's their communities. And its policies and legislation that help communities, bolster communities and give them what they need, which is essentially money, right? It's very simple. Like all of this is extremely simple. give people money, give them a fair level playing field. If we eliminate poverty, we know that families do better. That the beginning of COVID there was like this frenzy, in the parent defense and in the family policing space of we are beside ourselves, because kids aren't going to be physically in school. They may not be going to doctor's appointments as much because of the pandemic. We don't have eyes on these kids. What is going to be happening, rates of physical sexual abuse and neglect are going to skyrocket. And what we learned is that the polar opposite happened, rates of reported and abuse and neglect significantly decreased. One of the key reasons for that is something that our government did something that we did, right in my opinion, for the first time in a very long time. We address poverty in this country, we addressed child poverty. So through the American rescue plan, the child tax credit was passed, and this lifted 3.7 million children out of poverty. Let me let that sink in. And that is the biggest reduction in child poverty, I believe in our country's history. And it's something that we have to know this was killed in the legislator. by Republicans. It was wrapped into the build back better legislation. And it was it was not passed because of Republicans. But my point is that when you give parents and communities, material resources, what they need in turn As of having rent paid food on the table, these basic Maslow's hierarchy of needs, right, the things at the bottom right. Abuse and Neglect significantly decrease. That's what we need to advocate for a part of health care. This idea that health care and birth work exists in a vacuum, we need to step away from that, right? Like we have the potential to do a lot of good, right? You make somebody's birth as respectful. As you know, you focus on their autonomy, you recognize the trauma that that burning and the burning system in this country can impose. That doesn't stop when that baby comes out. Right? We as mandated reporters, making that call to Child Protective Services, the second that your patient leaves that birthing space, they've got the state in their business, we cannot provide truly supportive and trauma informed care while we are also arms of the state. And I think that is why we need our voices more in policy. We need our voices more in politics. We have a lot of power, you have a lot of power as members of a birthing and pregnancy care space. Take that to the legislator, advocate for these policies that help communities, lift children out of poverty, give parents what they need, and advocate against these laws that weaponize you and your, your genuine care for your patients.
Maggie, RNC-OB 31:34
Yeah, yeah. It's like, it's so it's, you know, it's both so complex and so simple. You know, like, it's what if that money just went to the families themselves, so that they like that that feels like very like, oh, I don't, I don't feel that. Yeah, it's very simple. That is never the option. That is never like the whatever. And I want to also highlight as we're talking about, like language, and I know this came up when we were having a previous conversation, if you could just speak to like, appropriate language around referring to foster care families, which I know is how I like but learn to speak about that. Could you explain to listeners kind of a little bit of that dynamic as we're talking with parents, if we're talking with patients, if we're talking about what is going on in the best wording around that?
Carlyn, LCSW 32:10
No, thank you for that attention to that question. That's a really important piece. So we don't say foster care of families. We don't say foster care parents, we use the language of foster care providers, because this is this is a monetary exchange, foster care providers are paid a hefty sum, depending on the state, it varies. I know in Maryland, it's I believe it's like 800 to 1000 bucks a month for a child. This is a financial interaction. And I think it's really really hurtful to birthing people to postpartum people to parents to show up somewhere and have this contracted, paid in, you know, entangled person with the state referred to as their child's parent and their child's family. And I think when we're we're looking at how to best support our patients, I think validating their experience, as you know, their experiences as a targeted and surveilled person of this state, I think is key. In so many cases, in all of the cases that I have worked, a parent has never intentionally harmed or neglected their child, this system doesn't make sense, you cannot logically wrap your head around it. And what it does is tries to break people down explicitly weaponize is your ability as a parent, your confidence as a pregnant or birthing person, it terrorizes communities through those those channels. So I think acknowledging that your your client, your patient, is the parent is really, really important.
Maggie, RNC-OB 33:53
Yes. Absolutely. And I know I've mentioned it several times. But you know, Dorothy Roberts book Torn Apart, I think her examples that she includes in that are really powerful for understanding this system. So if you are not someone who has been personally entangled within the family policing system, and you want to have a better understanding of what kind of happens when folks become part of it, she includes so many powerful stories that illustrate the minute starting incident. And then all of the things that come from that and we will be giving away a copy of that book that week that this podcast comes out to so if you are interested in that, check out our IG. But I just I think it is so important to like to read this book to dive into and to understand the incredible level of how invasive the family policing system is into into a family's life. How I know as I read some of the stories and I pictured the same situation happen to my family you know when instance like right a child wanders off at a park. Wait. I mean, we, you know, I'm watching two kids, I can only see so many things at one time. Sure, it has happened to most of us. It could happen to any of us, right? How if that was reported, and then I had to justify every single thing I do as a parent, I have to justify everything about our house, what food is available in the fridge and the pantry, how, how many piles of things are sitting around the house, all of those things that they're just so incredibly invasive, and they are personal. And there are so many different approaches to being a good parent. And none of that is acknowledged within the system. So I just want to give like a shout out to to tune into that idea of like putting ourselves in the other shoe. I feel like I know, within working within burning spaces for the last decade plus, I have heard so much judgment and negativity around people who are in our care. So really gross. And I think so much of that is a lack of its lack of empathy, right? It's a lack of imagining how just like differences in our personal circumstances, could put us in a different situation, as you kind of share a little bit about what are the things that we can do in the birth base? What are the things we can do to advocate different and better for folks to kind of take ourselves out of that, like the funky power dynamic that puts us up here, and we're looking down on those who are in our care, so that we are showing up better for them so that we are contributing to healthy, whole families, as they navigate any number of personal circumstances, I think that would be really helpful.
Carlyn, LCSW 36:42
Yeah, so a couple of things. Looking to the people that have been doing this work and who have been impacted by the system is the first and foremost, this is a system that black women have led their crusade against. I'm thinking of Joyce Macmillan at JMac for families, just an angel of a human and a crusader for families. I cannot recommend checking out her website her story enough. She's out in New York, you have April Lee Community Legal Services of Philadelphia, a friend and dear colleague, crusading the fight against this. We have mandated reporters against mandated reporting I mean, an interdisciplinary group that comes together to talk about how we can kind of exit this system of mandated reporting, being arms of the state, you know, eyes and ears of state violence, there are people doing the work. And I think often one of the the insidious, violent ways this system gets us is by siloing us that we there is power in numbers, we have power as humans, as defenders, as healthcare providers, when we work together, we are more powerful than the powers that be. So I think the first thing is tapping in to the folks that have been doing this work and have been most affected by this system, largely Black women, I think turning to Black women for their input and their their voice. And this is the fundamental thing that we can start by doing. The other thing, I think also is something that you touched on, which is this level of empathy, that that sometimes we are robbed of in these systems, we have to understand our biases as health care providers as birth workers. And we have to understand, I think that we have to understand the system that we are working in is the way it is for a reason. It's a hierarchical system. It is a system of power, historically present day, in order to dismantle that we really have to understand where we fit into it and what we can do together to dismantle it and come from a anti oppressive framework come from a harm reduction framework, and it's something that's really hard. I've been on the show before I've talked with you before I was an l&d social worker, a perinatal social worker at a urban one of the largest birthing centers in our area. And it was something that I really struggled with being this mandated reporter but also trying to provide this trauma informed anti racist care. It was something that I really struggled with and I really grappled with and ultimately I left it. I now work in family defense, it radicalized me, but it is a space that we need. We need providers that give a shit we need people that understand critically understand the systems that we're working in, while also fighting for change. Yeah, yeah. And we can't do it alone. Yeah,
Maggie, RNC-OB 39:54
absolutely. Absolutely. I wonder I know you had touched on things we can do, especially within the hospital. system right for someone to this mandated reporting happens around prenatal care, you know, things that come up intrapartum, you spoken to a couple of changes we can make with charting, and how we kind of can we can stand more firmly in the advocate role.
Carlyn, LCSW 40:13
Yeah. So I always say this to other social workers to people that practice therapy, I have a background in therapy to write your notes, assuming they are going to be read in front of a judge or a magistrate in parent court, I cannot tell you, I mean, I know almost every scene a case. So in our just a quick aside, like in parent defense in the state of Maryland, it's not family court that we go to it's what's called child in need of assistance court. And it's like that in most states, but in CINA court, when there is a petition filed when the state comes to the court and says, we're going to take this kid, or we're going to become involved in this kid's life. They come with evidence, and that evidence is not always credible. And oftentimes, it's fake and can't be corroborated, or whatnot. But they do oftentimes come with medical records. And in that medical records, every bedside nurse, I have read bedside nurse notes, I've read what often providers consider to be benign Social Work notes, charting in a way that is strengths based, gets the basic stuff, I mean, I'm not going to tell a nurse how to chart but like, gets across the the basic medical stuff without writing a thesis and without putting in your opinion, or your clinical presentation that that may not be kind, I don't know, the right word,
Maggie, RNC-OB 41:46
but ya know, what we taught? I mean, we've talked about trauma informed charting before Yeah. And Atkinson, and, you know, huge bass she talks about is like, anything that you're putting in that chart like singing? Would you read this aloud to the patient? Would you reassign the person who's in your care, because if it is something that is happening, whether it's in a positive or negative light, like if it if you are charting objectively, then there should be agreement about it, right? Like, the chart is not like some, like, mean, girls are passing notes. And we're like, giving like a wink to someone else about that it's happening. And I think that comes up a lot where we think we need to, again, it's all of the covering our own butts kind of piece of it, but really working to expand our vision beyond that piece of it, thinking way outside of that to thinking how is this going to reflect? How am I going to reflect on the person who is in my care? How does it reflect on what they actually need, what support they're looking for, we're not making things up, we can focus and highlight those strengths, we can speak about support that would be helpful in a way that we all need support, not that this person is failing. And, and these are all the reasons that they're going to be terrible, you know, and like us so much that it gets across that way. Like it's this it's all very negative and like, honestly, just judgmental, and we really like to do a lot of that at the door. And it's hard. And so I don't you know...
Carlyn, LCSW 43:06
It's also, I would go a step further, you hit the nail on the head strengths based, right? By talk, though I did education around this when I was a social worker. There are difficult situations that show up in your triage that show up in the birthing space chart from a strengths based perspective, okay, your patient is having a difficult time. They're verbalizing that they're uncomfortable, they may be agitated. Why included in the note? Birthing person is understandably agitated as XYZ, right. Oh, okay. So you see them bonding beautifully with their baby. Note that, yeah, yeah, pregnant person is attending prenatal care. If they're not why, right. Patient attempted to obtain prenatal care. However, transportation due to multiple jobs is an impeding factor. I can't stress it enough, like your notes will come across a defense teens table, they will come across the CPS attorney, they are going to use them they're going to weaponize whatever you say. So your patient doesn't get their kid. And you know, another thing that we can do, we can work together, right? Many public defender's offices, many parent defense teams like to hear early. We love to hear from people before they get in front of that magistrate before a petition comes across our desk before there's a shelter hearing. If you have somebody that comes to your birthing center, your hospital to give birth and you know this is going to be a mandated report to Child Protective Services or the family policing system gives the patient our information contact us. We can work together we have I believe it's called legally pretrial but it's essentially when we work with somebody prior to actually like them being in the system and then being recalled Client, so much of that is us meeting them at the hospital, being present with them, seeing what's going on and informing the providers of like, Hey, we are this person's like, legal team. Let's work together, let's work together to be respectful of them. And that includes, you know, letting them be with their kid giving them the same level of care that you would give someone that comes to your unit with all of their material needs that are in the perfect situation like, yes, let's work together.
Maggie, RNC-OB 45:31
Yeah. Oh, thank you, I think that is such a than another call to action for us in terms of how we step into this advocate role, how we can make these changes in the way that we participate in the system. So that we are so that we are able to temper how we are part of this system, so that we can subvert some of these issues that come up. And that we are really standing with those we care for, if the idea is to provide care. These are things we can literally do. So finding who that is in your area. Who is it that works? With folks? I know you'd mentioned parental defense is unfortunately not a standard across, you know, all the states. But what are the are there other organizations that work within this? Who who kind of gets involved with parents and knowing those, if you have to make a mandated reporter for your job? I'm trying to think about how do you are there times when we can skirt that system? Or are there times when we just say I have this and so then I also am going to make sure that this parent has the resources they need. I'm also going to reach out to the parent till defense like that there are multiple steps that can be taken then instead of just being on the side of I'm a mandated reporter, so I had to put this in,
Carlyn, LCSW 46:41
I think there's so two things, right. A good skilled social worker is skilled at getting around reporting. And when I say getting around reporting, I mean, bolstering the community to come and surround your patient accessing mutual aid, which is I mean, look, it's not the system that saves kids and families, it's the community, right, tap into your mutual aid networks, tap into your resources that are not connected with the state. Because if your if your red flags are going off for, quote, neglect, meaning your patients material needs are not met, give them access to that help them acquire that. Now I understand there is the you can't get around a positive utox at delivery, there's no way around...
Maggie, RNC-OB 47:26
I'm thinking of that one in particular, because that's yeah, what starts so many of it for us. And we also, if you have not heard it, and you're listening to this, Carlyn came on a few seasons ago and did an incredible episode that it's all about drug use during pregnancy. And I highly recommend that as well and harm reduction in that framework. But I'm thinking of that situation in particular, because I think that is one of those ones where there is this like objective data point, yeah, had the positive tox screen. And while we can try to avoid getting that we can think about stuff. Test people's urine, if for whatever reason, that step has already happened. And you have that, what are the kind of steps we can take from there?
Carlyn, LCSW 48:06
Absolutely. I think as you know, everyone listening to this is probably in the birth work world I, you know, coming from the birth rock world, and in some ways, unfortunately, like parent defenders aren't birth workers, like postpartum doesn't stop when your patient, you know, pops out a kid like postpartum never ends. Unfortunately, we meet a lot of postpartum people under duress. But I think like, as healthcare providers, right, we, when I was in that field, like we would come to this from the lens of do no harm and advocating for your patients and making sure that autonomy and dignity are prioritized. And I was recently in this training, look into it. It's the UpEnd movement, but Alan Dettlaff and a bunch of other badass social workers, historians, community members are fighting to dismantle this system. And they recently put on a conference with Marianne Mae Kambah, who's an another like, just angel to Earth, you can read her book about abolishing systems and abolishing the police. But she asked this question and I sat with it and was just like, my mind was blown. But she asked during this training, like a commitment to police or the family policing system means that you have to ignore many things. And she asked us like, what do you have to ignore? And I think that translates so well into this discussion. Because as a health care provider, you're probably on one end, you're prioritizing the care and the well being of your pregnant or postpartum person that you're taking care of. But at the same time, we're ignoring this massive elephant in the room and this massive purveyor of harm. I mean, honestly, like, what are we doing if we take such good care and pay such mind to pregnancy and birth. But that person walks out of your care and doesn't have their child like, what are we doing? You know, yeah, we're ignoring this massive piece. So I hope through your listeners take that away.
Maggie, RNC-OB 50:16
Yeah, it's also complex, right. None of this is, is easy. And I think whatever we have, you know, it's, it's, it's always hard we, you know, we have this like finite time to discuss while I could continue talking to you about this for all day, you know, we have this like a little bit of time to try to dive into some of this, and I know it it often. And we'll get comments and questions from because it leaves people wanting more, right? We want to understand the system that we're part of better, right, we want to be a part of changing it. And I am so glad that you were able to come and have the conversation with us because I think it is disingenuous for us to talk about community within birth care within how we relate to each other within how we relate to those who are in our care, without acknowledging all of these other systems that are a part that folks walk into right, like, community does not just mean that like, oh, yeah, we offered a postpartum group for new parents to come to and talk about, like, that's great. And we have to be paying attention to all of these other systems that our parents are a part of, right, like all of these other things that are that are going on, like you said, it's not just this little like bubble, in the hospital on our unit. And I think we have been trained and it's explicit, and it's intentional, we've been trained to think that that is our only zone, right? That's my role. I'm labor and birth nurse. So I am here, that you on this unit of between labor and delivery, and postpartum. And that's where I'm allowed to, like, exist and interact with folks, right. And it causes so much harm, because we are not aware of this bigger context that is going on.
Carlyn, LCSW 51:50
I think that's what becoming an abolitionist is, right. It's acknowledging that we show up to this work, not by ourselves, we are part of a community, we are part of a greater vision, right? We can and should always come with positive regard, but radical optimism, transformative justice, and the well being of communities will never and has never lived in the state, the state is not going to fix this. And those that work will come from us. I cannot speak to hospital work anymore, because I don't do it. But when I was there, these hospital administrators don't give a shit about you, you are abused and completely taken advantage of in the birth work world. If you're in a hospital. It's on purpose. You know, we have to maintain this, this radical optimism that we can and we will do better. In a lot of ways, it's hard because at the end of the day, you leave your beat down. It feels overwhelming, but it's meant to feel that way on purpose. It's meant to, to create this feeling of helplessness. But I mean, the some midwives, the nurses that I worked with, like some of the greatest people and most passionate advocates, we can do this, but we do it together. We do it. As you know, members are of our profession, we do it as members of our community. Community will save us and we need to get back to this imagination. We need to reimagine our future, because it could be a really great one.
Maggie, RNC-OB 53:31
Yeah. Which he's perfectly for our final question of our guest this season, which is, what does the future of community birth care look like for you?
Carlyn, LCSW 53:39
Community abolition and community? I think abolition is is what that looks like for me. Because truly until we have until we have abolished these systems of oppression, we cannot stand in radical, progressive, patient centered care. And being in community with one another is how we get to abolition. So, you know, it's a tough topic. It's like my coworkers and I joke about like, people be like, Hey, how's it going? Or like, Hey, what's going on? Like, this is not a fun topic like this is not that I mean, pattern snacks. This is a lot to sit through, but we can do it. And we do it together.
Maggie, RNC-OB 54:26
Well, thank you so much, Carlyn for coming on and sharing all this with us. I know these are this is a big topic to digest. There is a lot of reflection that I think most of us have to do about kind of understanding unlearning relearning, considering the narrative we've been told about these systems about our role within it. And I am really grateful for you creating this this space for us to start to ask ask ourselves some of these questions and consider how we can be a part of a different future.
Carlyn, LCSW 54:54
I really appreciate you and your advocacy. Thank you. And it's you know, this is a space where I look to the people I've been doing this work and have spoken out for decades. So definitely check out anything that Dorothy Roberts has written, especially now post jobs. We're all in a huge predicament. So Dorothy Roberts, Joyce Macmillan, April Lee, movement for family power, there are so many opportunities to learn and become engaged. I will link you and your listeners to all of them. But we can do it. We got this.
Maggie, RNC-OB 55:30
Yeah, we do. Thank you. Well, I so appreciate Carlyn and her advocacy and coming on and just sharing so much important insight with us and historical context so that we can really make sure that, you know, as we continue to navigate and establish ourselves within our community, we are aware of all these factors that are in play for our patients, for families that we support, and that we're able to have more educated and nuanced conversations around how we advocate with families. So we would love to hear your feedback from this episode. You can find us across social media, we are your birth partners, and we'd love for you to share a highlight in your stories on Instagram and tag us there so we can see what struck you till next time