Online Program

Motherhood and child custody loss among female street sex workers

Tuesday, November 3, 2015

Mina Farahzad, PhD, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI
Laura Cassidy, PhD, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
David Seal, PhD, Global Community Health and Behavior Sciences, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA
Staci Young, PhD, Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI
Sheri Johnson, PhD, Medical College of Wisconsin, Milwaukee, WI
Kirsten Beyer, PhD, MPH, MS, Institute for Health & Society, Medical College of Wisconsin, Milwaukee, WI
Background: Female street sex workers (FSSWs) are an extremely disadvantaged group who experience high levels of stigma, poverty, violence, substance use, and depression. Nearly 90% of FSSWs are mothers, and they strongly value this role.  However, many FSSWs lose custody of their children, causing loneliness, depression, and substance use.

Methods: FSSWs were interviewed about motherhood and loss and their relation to sex work, substance use, and depression. Common threads were identified using analytic questions, and emerging themes were refined using the principles of grounded theory.

Results: Women discussed relationships with their own mothers, which influenced their definitions of motherhood and coping with parenting. Nearly all women expressed a feeling of dirtiness associated with sex work. Substance use was often used to numb the pain of trauma and disdain of sex work. While some women were able to mother while using, most noted that drugs decayed their ability to be a responsible parent. Losses of children were major events in women’s lives. A few women were motivated to get clean to regain custody; however, most women were overwhelmed by guilt, shame, and loneliness, leading to serious depression and increased substance use. Women’s hopes for the future often involve reconnecting with children.

Conclusion: Motherhood seriously impacts perceptions of self-worth, and women associate loss of custody with failure in their basic role as women, often leading to devastating repercussions in their lives. Interventions for FSSWs who have lost children to mitigate adverse mental health outcomes and support healthy reunification are needed.

Learning Areas:

Advocacy for health and health education
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Define "motherhood" as understood by FSSWs. Discuss the role of intergenerational relationships in FSSWs' meanings and experiences of motherhood. Identify ways in which sex work, depression, substance use, and mothering are related in the lives of FSSWs. Compare various FSSWs' experiences of and responses to loss of children. Formulate the beginnings of a discussion around appropriate intervention for FSSWs who have lost or are at risk of losing their children.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted this work as my doctoral research, working closely in developing this project with women engaged in street sex work for over 2 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.