“I felt for a long time like everything beautiful in me had been taken out”: Women's suffering, remembering, health, and survival following the loss of child custody

Background: Child Protective Services’ (CPS) placements of children in out-of-home care are increasing and disproportionately impacting families marginalized by poverty, racism and criminalization. CPS’ mandate to protect children from neglect and abuse is frequently criticized as failing to address multiply determined social and structural issues impacting parents’ lives, and most often mothers. Objective: This research aimed to explore what is produced in this failing, examining the layered health and social impacts of child custody loss on women who identify as drug users, and the role of intersectional forms of violence both giving rise to custody loss and mediating its consequences. Methods: We conducted a thematic narrative analysis of in-depth interviews with 19 women drug users. Results: Trauma was identified as a key impact of separation, further exacerbated by ongoing mother-child apartness. Women described this trauma as unbearable and reported persistent symptoms of PTSD, and other mental health conditions. Practices of dissociation through increased use of drugs/alcohol were revealed as central in tending to pain of separation, and were often synergistically reinforced by heightened structural vulnerability observed in increased exposure to housing instability, violence, and initiation of injection drug use and sex work. Women’s survival was described as hinging largely on hopefulness of reuniting with children, a goal pivotal to women’s sense of future and day-to-day intentions toward ameliorated life circumstances. Conclusions: Findings highlight need for strategies addressing women’s health and structural vulnerability following custody loss, and also direct attention to altering institutional processes to support community-based alternatives to parent-child separation.