When children come into foster care, there’s often a need for neglected doctor visits and dental care to be tended to.

One of the first things I was told by the social worker after the twins’ placement was to get dd6 a hearing test. I took her to the doctor, got the referral for the hearing test, and then submitted it for an appointment. Soon after I was told it was denied because she had a hearing test just a few months before, and that I needed to be in touch with her past foster mother for the results.

Since the results of the hearing test weren’t submitted to the doctor, it wasn’t on her record. I don’t know if their social worker wasn’t notified that it was done or she didn’t notify the committee, but that’s the kind of thing that can happen with foster care. Happily, otherwise all is well with her.

Next, I took ds6 to the doctor to get a baseline checkup for him. It turned out to be very very fortuitous that the local pediatrician on their health plan is actually a pediatric endocrinologist. She requested labwork for him, and when it came back normal, told me she wants to run more tests. Most doctors would have left it at that – his numbers are ideal so there’s seemingly nothing to do.

Since this is her area of expertise, the perfect bloodwork creates another questions and she wants to determine if daily medication is actually necessary – is his blood work perfect because he has the ideal medication amount or does he not need medication at all? There’s nothing in his medical record that indicates why he was given this medication or diagnosis; when there’s an issue like this there’s supposed to be blood work done every three months. His last blood work was in 2019, over four years ago.

She gave me a list of tests he needs; none of which could be performed in either of the two cities a half hour drive away for several months. Since I didn’t want any further delays in having this taken care of, I took the earliest appointments available, regardless of distance. That resulted in an hour and a half drive for the first appointment, only to be told that I needed an additional doctor to do this test with the technician, and that doctor wasn’t available at that location. Not only that, the receptionist didn’t know when or where or how I could schedule an appointment with both of these people simultaneously if I called the scheduling hotline.

The receptionist was very apologetic and so helpful. Early the next morning she took the initiative to directly contact the only technician in the health clinic staff who has the expertise to perform this testing without a physician. She told me that if I got to a different city (also over an hour away) within the next few hours, he would take us without an appointment. I had plans for the morning and all the kids were home, but off we went, hoping to make it before it was too late. Thankfully we made it.

I took those results back to the pediatrician. That test brought up another concern that necessitated a visit to a different specialist in – yes – a city over an hour away. I was able to get an appointment a couple of days before Rosh Hashana. She was an older Russian physician, who harshly asked me why I waited until he was six to take care of something that should have been done when he was two. I covered the ears of ds6 and told her I’m his foster parent and am trying to get all of this taken care of as quickly as I can. As soon as she heard that her judgmental attitude and icy demeanor dissolved.

The next morning I took him to the dentist to get his teeth checked out. Amazingly, he had no cavities. I don’t even understand how that’s possible but I was so relieved. Afterwards we did some shopping together to make it a special Mommy outing for him, before taking him back to school. It’s always nice to have one on one time with children, and he loved it.

The most recent specialist visit resulted in a referral to a hospital procedure that ds6 will need. The last time I called this hospital I spent twenty five minutes waiting for a person but did get someone, and hopefully by the end of this week I’ll have that appointment made.

As far as hospital appointments, I’m still waiting to have a different test scheduled at a different hospital. (The hospital closest to me doesn’t perform this testing for children under ten.) It took a month of calling until I got a live person to tell me that I needed to submit the referral by fax or email. To do that, I had to return to the doctor and request that the referral be printed out since the hospital can’t access the computer records, then have it sent it. It’s been several weeks and I haven’t yet heard back from them.

Once I have all of this testing completed, I can go back to the pediatrician to evaluate what is going on with him. It’s been really busy taking care of all of this on top of the other things going on, but I’m so appreciative of her thoroughness and expertise, and hope that soon we’ll have resolved the issues that need to be addressed and have clarity about if there’s anything else he needs to stay healthy.

Avivah

The last couple of weeks have been extremely busy and left me with little time or energy to share with you here.

Some of you have asked for feedback after my last post about how d6.5’s first visit with his birth parents went.

Before the meeting, my husband told me his intention is to restore the dynamic of trust and communication we had with them at the very beginning. We jointly agreed to adopt this attitude, and both of us communicated with them in this spirit.

It took a lot of courage and emotional energy to have this meeting, but I’m glad we did. The meeting went very well – it couldn’t have gone any better. Of course ds was very cute and engaging because that’s how he always is, and they seemed to enjoy seeing him.

At one point, ds said to his birth mother, “When I was a tiny, tiny baby I was in your tummy.” He was waiting for confirmation and when I glanced at her I saw she didn’t understand what he said, so I repeated what he said. She looked a little misty eyed at that, but nodded at him.

I told our social worker when they initially said they would come for a visit but didn’t update her when we made more concrete plans because: 1) I was emotionally drained thinking about it and didn’t want to discuss it, and 2) I wasn’t sure they would show up. She was shocked when I confirmed they had actually come.

Since his bio parents until now hadn’t shown an interest in being actively involved, the committee recently decided they want to push for us to be allowed to adopt him. Since this decision was predicated on their uninvolvement, my social worker expressed concerned that beginning visitation will affect the negatively impact the adoption discussion. When I made plans for them to meet him I knew this could happen but nonetheless felt a person deserves to know his roots and it would be selfish of me to deny him that if I had any way to impact them being part of his life.

I’m so glad we did it. Buried in the back corner of my mind has been the concern about how and when to broach this topic, and now it’s openly on the table and we can talk about them freely with him.

We asked them if it would be okay to take a couple of pictures of ds with them, so we can print them out and add them to his personal album of his birth and early months. They agreed, and I sent them the pictures as well. They sent me a pleasant email thanking me for the pictures and said they had enjoyed the visit.

Will they come again? I didn’t ask them, but did tell them we would welcome regular visits of whatever frequency they are comfortable with. They bought ds some treats and when he said something about them buying him more ‘tomorrow’, I told him they weren’t going to be there the next day. His bio father hastened to add, ‘next time’. So hopefully now that the ice has been broken, more visits will follow.

Thank you all for the good thoughts and prayers on our behalf. I’m sure they were a positive force for us all!

Avivah

I mentioned recently that August was a milestone month in a number of ways for us. It’s a milestone in an additional way, one that I was thinking about a lot when I went to see my newest grandson for the first time a few weeks ago.

As I was holding him, it occurred to me that he is the third child of my third child (also born in August). We made a huge, life changing decision when my third child was born, a shift that affected everything in our family that happened ever since then.

Until that point, I was the breadwinner in the family. My husband was a full-time avreich (Torah student), and we lived a very idealistic, simple and mostly happy life.

The issue that was becoming more and more of a conflict for me was needing to rely on others to care for my children. When I had to go back to work after the birth of my first child, I looked for a babysitter close to my office. Our baby traveled an hour in each direction with me from our home to my office, snug against me in a baby carrier. I worked from 8:30 – 1:30; I nursed him when I dropped him off at and picked him up from the babysitter (a lovely woman who was the mother of six children). Mid morning my babysitter would call and say, “Avivah, your baby is hungry,” and I’d dash out to nurse him.

When he was young toddler, he started gan (preschool). A van would come to pick him up and drop him off. We took him to one neighbor in the morning who put him on the van since we had to leave before it came, and then a different neighbor would take him off the van, since I wasn’t yet home at that time. I’d get home around 2:45 pm, and then I’d spend the rest of the day with my two little children.

Until that point, I took my children to private babysitters who were neighbors or friends who cared for children in their home. It was a home environment, there were a limited number of children, and it was just one caretaker other than myself, minimizing the attachment difficulties for a young child. It was as good a setup as I could find and though I didn’t love it, I overall felt fine with it.

However, I felt increasingly concerned about my son. One day I got a call from the morning neighbor who saw my son had been dropped off in the afternoon on the sidewalk in front off our building, and the afternoon neighbor I was paying to take care of him didn’t get him. He was left standing there, 2 3/4 years old, not knowing who was going to take care of him and unsure where to go, until the morning neighbor took him in and then called me.

I was on the bus home when I got this call, and it tore my heart. There was literally nothing I could do about it at that moment. I didn’t read any books or get any message anywhere, from anyone, that maybe something wasn’t good about this kind of childcare arrangement. After all, this is the kind of thing all working mothers had to do, and I was fortunate to work it out as well as I did.

Rationalizing aside, I had a strong gut feeling that this was too high a price for a small child to pay, and that day, I told my husband, I can’t and won’t do this to our son anymore.

I was also exhausted all the time and though only in my early twenties was constantly wondering, “Is this what my life is supposed to be like, racing on a hamster wheel?” I had a decent job that I enjoyed, I had a wonderful husband and adorable children, and a job I did well and got positive feedback for on a daily basis. It didn’t make sense to give all of that up, did it?

It was two months before I was due that we made the decision that when our baby was born, I would stop working. How would we manage financially? Well, with three children ages three and under needing childcare, that would have taken 3/4 of my income, so I wouldn’t be coming home with that much once I paid all the babysitters. When we did the math, we figured out that if we would simplify even more and my husband could get tutoring work, we could make ends meet.

That’s what we did. It was tight but the feeling of happiness I had when every day, I put my own son on the preschool van in the morning and later in the day took him off, was euphoric. It felt right.

Being home with our children continued to feel right throughout the years – I’m not saying it was always easy and I was continually glowing with happiness, because it wasn’t and I wasn’t. Periodically there would be life circumstances that would cause us to reevaluate if this was still something doable for us, but my husband and I continually came back to the decision that it was best for our children that I be home with them full-time.

That was a long time ago – my third child just turned 27. Now it’s my own children that have to make the tough decisions that we faced about working with young children.

When I think of young families today, my heart goes out to them. Even if they have an awareness of the importance for young children of being with their primary caregiver around the clock, logistically it’s so daunting for them.

My husband and I made the decision that was was right for our family, and we’ve continued to live simply and frugally throughout all these years to continue to make this possible. We’ve had many experiences we couldn’t have had if I had been spending the bulk of my day working outside of the home. But more than that, I had the inner peace of knowing that I was able to be the primary caregiver for our children and create a sense of stability and consistency throughout the years as we experienced big and small changes.

If you’re living in the modern world, regardless of what community you belong to, you have to be somewhat countercultural to make the choice to stay home with your children. You need to be very intentional and thoughtful to find a way to meet the needs of the children in a world in which working women have become the norm and daycare an option that is seen as just as good as being home with mom. (It’s not.)

Am I critical or judgmental of women who work outside the home? Absolutely not!

What does deeply concern me is that I don’t see the crucially important societal conversation happening about what is best for young children. Children have needs that have clearly been proven to be necessary for their healthy emotional development. We don’t have to guess about this.

We don’t want to make mothers feel bad by bringing up the concern about how children might be negatively impacted if she isn’t able to be present with them for a number of hours a day – but the children can’t speak up for themselves. They literally have no voice. And if a mother has never heard a different perspective or had information shared that might affect how she makes choices, how can she make an informed decision?

I’d like to encourage parents to learn about the attachment needs of young children, and then think outside of the box about how to meet the needs of our youngest and most vulnerable. Maybe you need to work for financial reasons, but is there a way to work from home, or cut your hours, or cut your expenses, or work alternate hours when your children are sleeping? Can parents alternate their schedules to minimize the time children spend in the care of others, or can they be cared for by relatives or friends?

There are no easy answers but my experience has been that it’s worth asking those questions. When you get clarity about what you want, possibilities and solutions you didn’t consider previously often appear.

What benefits children will benefit families, and benefit our society at large. I don’t think having more children grow up with a healthier sense of themselves can be anything but positive! This isn’t an issue of compromising our needs to make someone else happy, or giving up what matters most for something inconsequential. It’s quite the opposite – finding a solution that you know meets the needs of your entire family creates more peace and contentment for everyone.

Avivah

Six years ago we took ds6.5 directly home from the hospital as a very small infant, and in every way he’s grown up as a member of our family. Everyone in our extended family thinks of him as a sibling; no one looks at him as a foster child. As far as we’re concerned, it’s just a technical legal term.

When we had the initial conversation prior to his placement with his bio parents, they indicated they would like to visit weekly, which we warmly supported. We had always assumed we would tell ds6.5 from the time he was very young about his birth status, in conjunction with the ongoing visits. He would grow up with this being an accepted part of his life.

However, there were only two visits when he was a newborn, and then two and a half years later a very short visit. And so the conversation never happened.

As I began researching foster care and adoption trauma about six months ago, I was taken aback to learn that often babies adopted at birth show the most trauma. I couldn’t initially understand why that was. After all, if a baby has known love and security from his first weeks, how could it be possible that sometimes he was emotionally worse off than a child who was abused or neglected and only found a safe home at a later age?

I had to hesitantly tiptoe around the answer, because I lot of emotional resistance to learning more. I didn’t want that to be true. I didn’t want to think that the infant that I had raised from so early in his life, who I slept with on my chest as a tiny baby so he would feel secure and to encourage bonding, the baby I spent two years gathering mother’s milk for from various donors all over the country to keep him as healthy as possible, who we all loved in a whole-hearted way from day one – I couldn’t accept that he could emotionally be missing anything.

It was very difficult for me to listen to and read extremely negative perspectives from adults who were adopted, perspectives I had never been aware of and therefore never considered.

I may have been resistant but my nature isn’t to ignore information I don’t like.

Unborn babies begin to bond with their mothers in the womb. Thus, there is an emotional bond that is broken the moment he is born and his mother isn’t there for him. What has been termed ‘the primal wound’ is the baby’s loss of his mother; he is fully aware of this loss though he will later likely never be able to verbalize or even remember it. This pain can stay with him for life and impact his later sense of self and relationships.

Though I began doing this research because the possibility of the twins coming had been broached, I began thinking a lot about ds6.5 and what this meant for him.

I would love to think that by raising him as we have (and this is what I thought until recently) from as young an age as we did, that we took away the short term pain of the loss he experienced. What I’ve learned is the pain of that loss is forever.

What I care about most is doing what is best for him, and thus, I strongly requested through my social worker that his bio parents visit him. At our meeting, that subject was raised by the social workers and I added my voice supporting that preference. They weren’t interested; the social workers told me they don’t have a way to compel birth parents to see children if they don’t want to.

Soon after his bio father called me and I made a direct appeal, telling him that this is best for ds, that he should know who they are and have a relationship with them. He called me back a few weeks later and told me he and his wife were planning to go away to the north for a couple of days in the beginning of September and would try to visit then.

I asked him to send pictures of them both so that I could begin the process of introducing the topic to ds6.5. He did send a picture, but it took a few weeks. By the time I received it and was able to get it printed out, I had a week until their visit to break the news to ds6.5.

My stomach was in knots thinking about how to go about this.

Fortunately, dd6 made it easier for me. Being a child who came into foster care at a later age who knows her parents, our conversations about family are very different. My daughter gave birth three weeks ago and her family stayed with us until yesterday, so we got to see a lot of them. Dd wanted to know where the new baby came from before she was born, so I told her she was inside her mother’s tummy. (I realize that’s not anatomically accurate but that’s what I say to young children.)

She asked about whose tummy she was in before she was born, and I told her, her imma. I explained that her brother also was in her imma’s tummy before he was born. She was processing this, and then wanted to know which children in my family were in my tummy before they were born. (With my daughter’s family here, she was confused about who were my children and who were my grandchildren.) After clarifying which children were my daughter’s and which were mine, I told her that all of our children were in my tummy and all of my daughter’s children were in her tummy.

“What about ds11 and ds6.5?” she specified. I try not to say something not true and told her they were also my children, then changed the topic without specifically saying ds6.5 wasn’t in my tummy. She went on to ask this question a couple of times more in the last couple of weeks.

Then last week the twins had a visit with their parents and came home with balloons and scooters. Ds6.5 requested to go with them next time to their abba and imma and also get presents.

He’s heard all the conversations going on. I realized that he already has the concept that children can be born to someone else and raised in our family, and he has an association that children can visit their birth parents who will give them gifts. I realized opening up this topic with him could be very easy, that it didn’t have to be the heavy conversation it was feeling like to me.

I printed out a picture of his birth parents as well as a number of pictures of him from the day we first met him and the day we brought him home three weeks later, and put them all in an album. I sat with him and showed him the album, and when we got to their picture, he asked me who they are. I told them, “This is the lady whose tummy you were in before you were born, and then you came home from the hospital to live with Mommy and Daddy.” “Really?” “Yes, really.”

He was very positive about this and went on to show his album to everyone in the family. He showed me their picture later on and told me, “They will be my friends.”

A visit was scheduled a week ago for this afternoon at a local park. Though our home would be the easiest location, I prefer we not meet here. Though I know they’d want to see where he lives and assess all of what we do and don’t have, I want to have some distance. It’s not a reciprocal relationship; why should they know all about my life while sharing nothing about theirs?

They asked if it would be appropriate to bring a gift, and I suggested a scooter, since that’s something ds specifically hoped to get by meeting the twins’ parents. I didn’t want to tell him about this too much in advance. If it was still vacation, I would tell him as soon as he wakes up this morning and talk about it throughout the day with him. But I don’t want to tell him and then send him off to school; that’s too loaded a topic to not be present to process together with him.

I also don’t want to keep him home from school because of this. So I’m going to tell him when he gets home, and then soon after that we’ll go together to meet them.

I get a bit of a pit in my stomach thinking about the ramifications of this. Just like it was hard thinking about how to tell him and then it wasn’t a big deal, this visit could be the same. Not a big deal.

I tend to be very sensitive to his birth mother’s feelings at the expense of my own, and I’m thinking about how to hold that line.

A couple of things were recently said to me by his birth father that didn’t give me warm and fuzzy feelings. One, when I asked him if it was helpful for them to know he was doing well, he responded, “No, that makes it worse. If he’s doing well, he should be with us.”

Secondly, in the next conversation when we talked about the meeting place, I told him I saw it was hard for his wife to meet in our home in the past, and that it would be better in a neutral place. He said, “You have to understand the heart of a mother. She feels you took her child from her.”

The sheer audacity and denial implicit in that statement took my breath away. I don’t remember if I said anything in response. When we initially met they were so grateful to find us and we were the solution to their problem – a baby they weren’t going to keep and there were no suitable (to their mind) charedi families to take him, a baby left in the hospital for eight weeks until he came home with us – but in her mind as time passed, I’ve somehow become the source of her pain.

I think it’s going to be extremely hard for them to see him. We expected he would do much better if raised by us than the average family because of our parenting approach, and he has. He’s amazing. When talking with my daughter about the difficulties seeing how charming he is could present, she asked, “Isn’t there a way you could keep being so cute and smart just for that day?”

My husband trusts them to honor their commitment to us. They told us several years ago that they won’t take him back no matter what, and my husband believes they’ll keep to that even when they see he’s far more advance than they would have expected. I hope he’s right, I keep telling myself that he’s right, that they’re not going to take him away.

I’m doing this because I feel it’s right for ds, but not because this is easy for me. Personally, I would be fine with the status quo of them never seeing him if I believed that was in ds’s best interests. While the likelihood is that this meeting is going to go very well and tomorrow I’ll be able to share how well everything went, right now, I’m in emotional limbo.

Avivah

When children are in foster care, visits with their biological parents are supposed to occur on a regular basis. Sometimes the children visit the home where their parents live, and sometimes they have supervised visits at an alternate location.

In our case, the twins have supervised visits every other week. These visits take place in a center established for this purpose at the social services complex.

The first time I took the twins, it felt a bit like being in a spy movie. Since the parents aren’t supposed to see me (though I was told eventually the children will give them enough information that the parents will figure out who we are), I have to park down the street, call to confirm the parents were there, and only once the parents were inside could I park next to the building. Once I hear that they’re inside the center, I park in front of the building.

Then I take the kids inside the building where I meet the social worker who facilitates the meeting in the reception area, and she takes them to the center downstairs.

When it’s time to pick them up, it’s done in reverse. I go into the building, wait near the entrance and the social worker brings them to me. Then she waits until I’ve had time to pull away and only then the parents are told to leave the center.

These visits are important for the children and their parents, to maintain and build their relationships with one another. It’s just twice a month, an hour each time, and the children are so excited for each visit. I’m glad for them that it’s such a nice experience

Their parents bring snacks for the visit, and they also come home with snacks and presents. After one visit, ds6 had stomach pains for hours. He told me his stomach hurt because he ate so many treats. He was crying in pain all evening and woke up twice crying from stomach pains in the middle of the night; then he stayed home with a fever the next day. My social worker told me it was appropriate to let the social worker at the center know so the parents would have helpful feedback.

Each time they come out from a visit, each of the twins are holding family size bags of snacks instead of small individual bags. (That doesn’t include what they eat during the visit.) Knowing what amount is appropriate for young children isn’t intuitive or obvious to everyone. At the beginning of a visit, I told the visitation social worker how sick ds6 had been and requested that the parents give a smaller quantity of snacks; she shrugged and said she didn’t think they were eating too many snacks. Just an hour later dd6 came out of her visit and told me that her stomach was hurting.

I think it would be a kindness to let the parents to know things like their shoe size and what toys are appropriate for their age – they’re buying the gifts and shoes anyway – but the social worker doesn’t seem interested in sharing feedback with them. I don’t feel it’s fair to the parents or the children not to give them appropriate information. The parents give gifts that are minimally used and don’t garner much excitement, and the children get things that are of minimal value to them.

When dd6 received sandals that were too small, she was so excited that I let her wear them to school for a week, even though her toes were sticking out over the top. But after that, I put them away because they weren’t suitable. If they fit her, I would have had her wear them to each visit so her parents could have the pleasure of seeing her enjoy the shoes they bought.

Then two months later they were given flip flops – again, too small. If they had been told the childrens’ shoe size after the first pair of shoes were purchased, these flip flops would have been a gift the children could have enjoyed more. And the toys they are given … it’s a waste of their resources to give things that are hardly looked at after the first day.

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A couple of weeks ago it was their birthday, and on the drive there the children were excitedly detailing all the things their parents would bring them: bicycles and scooters and cake and balloons and treats and more. I cautioned them that it might be different than that and they’d have to wait to see what their parents brought.

Unfortunately, after arriving at the building we learned their parents wouldn’t be coming. When the social worker called to find out when they would be arriving, they told her they had called in advance to notify them that they wouldn’t be there that day, but if that was the case, no one got the message.

As you can imagine, this was particularly disappointing and painful for the children. There is always a lot of anticipation the day of the visit, and this time there was even more because of the birthday. While generally I don’t see any negative behaviors after the visits, that time it was really hard. Ds6 repeatedly cried for his father and for the entire afternoon and next day repeatedly insisted he had to see his parents.

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When I looked at the Facebook account of their parents, I saw a post in honor of their birthday: past pictures of the parents together with the children (all taken at the mediation center) and the mother’s beautiful declaration of love for her children. Following that were comments, one of which was, “The most perfect family ever!”

The father’s account had an equally beautiful declaration of love for them on their birthday, concluding with, “Dear children, all you have to do is keep growing and smiling. Leave all the rest to abba and imma, we’re taking care of everything for you.”

There’s no mention on either of their Facebook pages about the children being removed from their care, nor that they missed that important birthday visit. I found it so reflective of the artificial and manipulated world of social media that people can post a picture of their beautiful family and have gushing positive responses, while the well-cared for children they see are those I care for in my home, in the clothing I bought and dressed them in.

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While there are minor blips in the visitation experience, I’m appreciative that they have supervised visitations rather than in-home visits. Another foster mother told me of the difficulty in sending her foster children back to a violent home each Shabbos. They would come back agitated and stressed, and by the time they would calm down, it was time for the next visit. I’m so grateful we don’t have to deal with anything like that.

Avivah