Motherhood and child custody loss among female street sex workers

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.