by Tilda Shalof
“It’s about attachment,” Annie says. “It’s the most important thing for mother and baby.” Establishing daily routines, for example, fosters attachment. They give the baby a sense of security. Annie gets down on the floor with Rita and they play with Darwin. Annie coaches her, whispers cues, suggests gestures, words that seem to still feel deliberate and awkward to this young mother. She teaches Rita how to play Follow the Lead, a game in which the baby is in charge and the mother mimics whatever the baby does, talking to him all the time, but letting him have the feeling that he’s in charge. “Be a mirror for your baby,” Annie says.
Rita picks up Darwin with the attention you’d pay to a bag of groceries and takes him into the kitchen as if to unpack rather than feed him. Annie and I stay behind for a few minutes to allow her to get set up and so that we can talk.
“I never play with the baby myself. It’s very important that a mother doesn’t even once see him reacting more with me than her. She might lose her confidence. For some of the women I work with, you, the nurse, might be the first person who they can trust, possibly the only one.”
Annie has come to realize that trust may have different meanings to different people. “I had a challenge caring for one mother. I felt she didn’t trust me. ‘Of course I trust you,’ she said, ‘I let you into my house, didn’t I?’ Her definition of trust was not the same as mine. She was from a totalitarian, war-torn country that had been invaded, where citizens had no rights and the police could enter at any time. Allowing a stranger into her house was, for her, the ultimate sign of trust.”
As we wait for Rita, I look around the room. There is a plastic house, a wooden train, and a few stuffed animals. I remember the expensive baby paraphernalia I had, the mounds of shiny new gadgets and gizmos my friends and I bought for our babies – or was it for ourselves?
“This is good. Some mothers have no toys for their baby,” Annie says. “Each home you go into is a different world. In one, there may be so much dirt and clutter you can’t even see the floor, it’s stuffy and hot, the baby is overdressed, finances are limited, but the mom is confidently breast-feeding. Another single mom – upscale neighbourhood, the mother is anxious, isolated, having postpartum depression. Baby is dressed nicely. He gives a little holler, she panics. Behind each door, you’re swept into a different world. Some places there’s so much stuff, you can’t see the floor. It’s so hot and close. Mom is clutching the baby, won’t put him down. She’s freaked out, anxious. The place smells musty and mouldy. It’s not healthy, but you can only deal with one thing at a time.”
Annie looks mildly discouraged about today’s visit with Rita. Knowing Annie as I do, I’m sure she’d like to deal with a lot more than one thing, but she knows her top priority. “What I really need to do is instil in a mother a sense of the importance, the significance of this baby. A baby is a big deal! I’m not sure Rita sees it that way.”
Annie is concerned about Rita and her baby, but recognizes the limitations of her role. “All we can really deal with is the here and now, the basics like play, bonding, feeding. My expertise is fostering the bond between them by helping her get into her baby’s mind. It’s a skill that can be learned and is the first building block for empathy. Empathy – even for one’s own child – does not come naturally to everyone.”
Rita brings her baby back in and sits with us. She’s stiff and uncomfortable with him, holding him like he’s an inanimate plastic doll. She seems bored or disinterested in playing any more with Darwin.
Back in Annie’s car, I think of that image – it’s the picture of detachment.
Annie and I talk about words.
“They are so important.” Annie says. “There was one, a twenty-year-old Cambodian mother with a five-year-old son. He was completely dysmorphic, with no speech. I could see she had no idea how disabled her son was. ‘He’s lovely. You are doing a wonderful job,’ I told her. Her entire body eased with relief. ‘I thought his not speaking was my fault,’ she said. That opened the door for us to talk about his special needs. I didn’t use the word ‘disabled.’ ”
“It must be tempting to bring them toys. Rita had so few. I had so many when my kids were little. Too many.” I wonder if I could drop off those toys for Annie to give to Rita.
“Unfortunately, we can’t. No, it harms the relationship if we move too far over into friend mode. I use my self in my practice. Sure, I’m warm, genuine, and caring, but there is a boundary that I never allow myself to cross. Sometimes they’ll push a button or two of mine, but only I’m aware of it. I don’t let on. We are friendly, but we have to be clear about boundaries.”
Public Health Nurse Talia Singer also works for the City of Toronto. She’s involved with a program for pregnant women living on the street, called HARP (Homeless At Risk Prenatal program). We’re in the heart of downtown, walking to meet Kaitlin, a twenty-four-year-old cognitively impaired woman who gave birth to a baby girl two weeks ago. Talia is bringing a bag of groceries and toiletries to give to Kaitlin. “No one ever discharges a new mother from the hospital with maternity pads.” It’s one of Talia’s pet peeves, so she always puts it on her shopping list for her clients, along with groceries, food vouchers, bus tickets, and phone cards, all subsidized monthly expenditures for the young, homeless mothers Talia sees. As for the cellphone, Talia explains: “They need them. They may be homeless, but at least they’re connected. On average, I get over two hundred texts per month, per client. Sometimes they lose their phone or sell it for food or crack.”
Talia’s puffy winter jacket hides her compact figure and her curly chestnut hair is casually tousled. She is naturally pretty, but her good looks don’t seem to matter to her in the least. She’s been a nurse for twelve years, but is as fresh and enthusiastic as a new grad. As we tramp through the snow and city grime to get to a coffee shop, Talia explains that this baby Kaitlin recently gave birth to is her fourth, all with the same partner. Each time, the Children’s Aid Society has intervened and taken the baby, because Kaitlin and her partner, who’s currently out on parole on a charge of assault, have neither a home nor the skills to parent. “Kaitlin is upset because her doctor is pressuring her to get a tubal ligation to prevent further pregnancies.”
I stop short. “That sounds like a good idea.” I assume I’m stating the obvious, responding how anyone would after hearing even a snippet of that background, but Talia visibly bristles at my endorsement of the doctor’s advice. “You don’t agree?” I ask in disbelief.
“No, I don’t. Enforced sterilization in this country is illegal and unethical. It’s what oppressive regimes do, what the Nazis did to non-Aryans. It is used for ethnic cleansing.”
“But Kaitlin is homeless, cognitively impaired. She doesn’t have a stable partner.”
“Perhaps with the proper supports in place, Kaitlin could be a good mother. That’s what she wants. She wants to keep her baby.”
“I want to win the lottery, but that’s not going to happen.”
“If you’d been there in the hospital the day Kaitlin gave birth, and saw how she looked at her baby with love, you might feel differently. If you heard her wails when her baby was taken away, you’d feel her desire to be a mother. Kaitlin barely speaks, but that day, she made her voice heard. Who are we to destroy her dreams?”
“We’re supposed to nurse people’s dreams, too?”
“We all have dreams. She has the same dreams as you and I do. My job is to be on her side. She has no one else.” Talia is clear about her role, which still seems ambiguous to me.
“What if her wishes are unreasonable? Harmful? Irresponsible?”
“Obviously, I don’t support those, but I will agree to help her make healthy choices. That can only happen if she trusts me. All of this is about building a relationship. In my role we look at strengths. Her partner, Slade, has not been violent to her, they are not hard-core drug users, they want to be good parents.”
Talia is younger than me by at least twenty years but suddenl
y seems wiser and more mature. Why can’t I be as accepting and open-minded as she is?
“You must think I’m not very compassionate,” I say.
“No, I don’t. You ask the same questions my husband asks, that everyone asks.”
“Welcome to my office,” Talia says. In this bustling Tim Hortons, taxi drivers, university students, biker boys, and skater dudes stand in line for coffee and doughnuts. The language of the customers in front of the counter and of the servers behind is a mix of Hindi, Farsi, Jamaican patois, and Korean. The place is packed. No smoking is allowed, but it’s hazy inside and reeks of cigarettes and the city.
Soon Kaitlin and Slade arrive. They’re angry – he more than she – that their visit with their baby was cancelled because the foster parent was unable to bring her. They dig into the egg salad sandwiches Talia had bought for them. They huddle together, close to the table, warming their fingers around the paper cups of the “double-double” coffees she knows they like. Kaitlin’s running shoes are covered in snow and her once-white-now-grey thin ski jacket doesn’t look very warm. Slade wears a soaking wet black jacket and sports an earring.
“I’ll negotiate an extra visit with your baby for you.” Talia makes a reminder to herself.
They cheer up at that, especially Slade. “We’ll get her back one day,” he assures Kaitlin, who’s staring at the rack of doughnuts, seemingly transfixed.
I try to imagine these two as parents – I can’t. I decide I’ll just try to put all judgement aside so that I can be as open-minded and sympathetic as Talia is. I will do my best not to allow myself to think of this baby’s likely bleak future growing up in foster care. I make myself stop wondering how the couples I know who desperately want a baby but who struggle with infertility would feel about this. I push out of my mind the protest of taxpayers over assuming the cost for people who produce children they are unable to care for, not to mention the children themselves without a permanent home who might or might not become adopted. I force myself to stay in this moment and attempt to keep my heart as open as Talia’s is; I’m going to do my best to see what she sees without evaluating it.
“Maybe we could get more visits,” Kaitlin wonders. Crullers, dutchies, old-fashioned, sour-cream glazed. “The driver didn’t show. We didn’t get to see our baby.” Maple iced, jelly, chocolate dip.
“Hey, can you please make Kaitlin wash down there. I keep telling her that if you don’t clean it, it’ll get infected.”
“Do you have discharge, Kaitlin? Is there a smell?”
“It smells and it still hurts. You know, the place where I make pee-pee.”
I wonder if she is referring to her vagina or her urethra and if she knows the difference.
Slade leans forward in earnest. “I don’t want her to get an infection. Hey, did you tell Talia about your milk?” He grabs her breast and squeezes.
“All gone.” She holds up her hands and giggles.
Slade updates Talia about his battle with law enforcement. “They want me to go to anger management. They say I can’t control my temper. There was a knife assault, but they want me to plead guilty, but I’m not going to plead guilty for something I didn’t do, even though it would only be thirty days.”
“What’ll you do if Slade goes to jail?” Talia asks Kaitlin. “Where can you go to get food?”
While Kaitlin thinks that over Slade tells us his pre-jail plan. “Before I go back in – if I have to – I want to buy her a big pillow, shaped like a heart. For Valentine’s Day.” He whispers this as an aside so Kaitlin won’t hear. No worry about that, her attention is elsewhere.
Somehow, Talia gently manages to bring the conversation around to birth control.
“We still want a baby,” Kaitlin reminds Talia, in case she forgot.
“Yes, but for now, you need to give your body a rest. How about an IUD? It won’t protect you from STDs, but you two are in a solid relationship.”
She giggles, then pretends to pout and points a finger at Slade. “Sometimes he cheats.”
“No IUD,” Slade says. “I won’t have no plastic thing bouncing off my you-know-what.”
“This takes effect immediately. You don’t have to wait thirty days like with the pill.”
“We never did wait no thirty days last time.” He grins at Kaitlin.
“I will bring you one next time and show you how it works. You can decide together.”
“My doctor wants me to get my tubes tied. I’m not going to do that.” Kaitlin stamps her foot. The snow has melted and her soaking wet shoes make squishing sounds under the table.
Slade nods his head in agreement. “Nope. She’s not going to do that.”
“It’s your decision. It’s your body. Okay, so what are you two going to do today?”
“Get some groceries. We’ll go to the food bank. Then get high.” Slade sees something over at the counter that puts a scowl on his face. He nudges Kaitlin and points at two police officers standing in line for coffee, but she doesn’t get his drift.
“At the food bank, you don’t get to choose what you want,” she complains.
“What do you feel when you see the cops, Slade?” I ask.
“I hate them. All’s they want to do is make my life a living hell.” He stands up abruptly, suddenly eager to split. “Well, I guess I inhaled that food,” Slade says. “Let’s go, Kaitlin.” He tugs at her jacket sleeve to move her along but Talia has more to discuss with them.
“You know,” she says. “When we’re not meeting anymore, there will be no more food vouchers. How will you eat? You texted me that you’re only eating macaroni. Why is that?”
Slade shrugs in answer, glancing again at the police officers, then at the door.
Kaitlin giggles. “I don’t like the food bank. They just give you stuff. I don’t want tuna.”
“How are you managing with money?”
“We get $677 a month. After phone, food, and rent there’s twenty bucks. That’s for weed. I need that.” Slade folds his arms across his chest. “I need my weed. It keeps me calm.”
“Slade calm is a good thing.” Talia chuckles and pats him on the shoulder.
“I need some weed, right now.” He’s restless, shifting around in his seat. “I’m pissed because my lawyer says I have to do thirty days, but no, I have enough stress with the kid taken away. We have an empty stroller, an empty crib. I can’t do time now.”
“I put lotion on the baby,” Kaitlin pipes up. “I even got peed on.”
“You’re parents. You’re going to get peed on, puked on.”
“We know what to do,” Slade says. “Feed her, change her.”
Just give me the keys to the car, Mom. I know how to drive.
“But we can’t play with her yet. She’s too small for that,” Kaitlin agrees.
“Yes, she’s only three weeks old. You can’t play with her but you can talk to her and smile at her.” Talia checks her calendar. “Kaitlin, we have a month left together. What can I help you with?”
She squints back at the pastries in a way that makes me think she might need glasses. Slade shifts around in the chair, drums on the tabletop. “We need to move on. C’mon Kaitlin.” He tugs at her sleeve again.
Talia asks Kaitlin directly. “What can I help you with?”
They both stare back at her.
“What do you need right now, Kaitlin?”
She licks her dry, inflamed upper lip. “Chapstick.”
“Don’t lick it.” Slade slaps her hand playfully. She puts her fingers to her lips. “Stop picking at it.” They stand up to leave. Kaitlin’s coat flaps open to her still-swollen belly.
“When our visits end, I will give you names and numbers of people who can help you.”
“Can I still text you?” Kaitlin asks.
“Of course.” Talia is about to say goodbye, but Slade is not as anxious to rush back into the cold now that the police officers have left the coffee shop.
“You don’t have to say goodbye, Talia. Yo
u’ll be seeing us again. Maybe even nine months from now. We have a plan, right Kaitlin? Let’s tell her.”
Talia is bemused, interested to know what these two are planning. Me, too.
“We’re gonna keep on having babies until they let us keep one.” He grins at Kaitlin.
“It’s a plan,” she says, high-fiving him.
This plan drops on me like a bomb, exploding in my mind. I’ve lost my sympathy; I have no more compassion. I turn my back on them in my mind. Lucky they didn’t try to high-five me!
It astounds me how casual and easy is the act that results in something as monumental and significant as a new human life. I realize that now in a way I never have before.
Talia is nonplussed. She reminds Kaitlin how difficult her last pregnancy was, especially when she went into labour. How she had to use her last taxi voucher to get to the hospital the night she had early contractions. At the hospital, they told her it was false labour and they sent her off by herself with no taxi, coat, or boots, at two o’clock in the morning. She had to walk home, nine months pregnant. Somehow she got back to the hospital the next day, and when she had the baby, they kept her for twenty-four hours, then sent her home. Nine stitches, no maternity pads, no food, no home to go to.
“I’m going to miss you two.” Talia gets up to give them each a hug.
Talia looks at me. She senses I’m struggling to process all of this. “Maybe next time Kaitlin gets pregnant she’ll remember our good interaction and seek out a public health nurse.”
“Being pregnant garners them a lot of attention. Maybe they should get this kind of attention for not getting pregnant,” I suggest, trying to come up with a solution. “Don’t you worry that your supportive approach might be enabling their bad choices?”
“But the alternative – advice, judgement, scolding criticism, punishment – will only alienate them. Then we’ll lose them altogether. They need love.” Talia smiles contentedly, like the Buddha I’m beginning to think she actually is. “Slade has a nurturing side, doesn’t he?”