Mother-and-Child Reunion

By DAVID VAN BIEMA

Infant T, Infant M and Infant D occupy identical cribs in a small, drab ward on the second floor of Washington's District of Columbia General Hospital. A Fisher-Price mobile dangles above each bed. No one ever visits them. They have never been outdoors.

The babies were born in October, November and December. They have long since outgrown the maternity ward. They are healthy. In fact, there is no reason why any of them should not be home now -- no reason except that they have no homes. Their mothers left in a hurry weeks ago, providing only phony addresses and phone numbers before slipping back to cocaine habits and homelessness. Among the other things they neglected to leave behind for their children were names.

Abandoned babies were far less painful to contemplate before the crack and AIDS epidemics, back when they came swaddled in baskets with heartbreaking notes, in the thousands rather than in the tens of thousands. Now they are a shared social nightmare, the blame for which may depend on the political philosophy of the beholder. Conservatives might find it hard to imagine a purer shirking of personal responsibility than the mother who throws her child, at birth, upon the charity of the state; liberals may decry the forces that drive poor, addicted and HIV-positive women into this most wrenching and demeaning admission of failure.

Last November the Department of Health and Human Services, in its first such tally, reported that 22,000 "boarder babies" were deserted in 851 hospitals in 1991. Three-quarters of the infants tested positive for drugs at birth. They had no relatives, only nurses; no world beyond the ward. Some stayed in the hospitals so long they learned to walk there. Most were doomed to an early entry into America's brutal foster-care system, and in the meantime each baby's maintenance cost up to $1,500 a day.

But since 1991, at D.C. General and other institutions around the country, another story is emerging. The three infants with their mobiles, pitiful as they are, represent a sharp decrease from two years ago, when the daily census of abandoned babies ran as high as 25. "We used to have them in four or five rooms," says D.C. General's communications director, Linda Ivey, proudly. "Now there's only one nursery." New York City's Harlem Hospital Center reports that its daily count has plunged from 20 to three. At Grady Memorial in Atlanta, the annual total of boarder children fell from 52 in 1990 to 22 last year. The improvements reflect a courageous willingness to identify -- and tackle -- root causes. All three hospitals practice early intervention, targeting problem mothers during pregnancy. Each addresses not only motherhood but also the addictions and other tribulations that can make motherhood seem unendurable.

Grady Memorial's Project Prevent, funded by a $450,000 federal grant, is perhaps the most aggressive program, cooperating with Atlanta's police and homeless shelters to recruit pregnant drug abusers. Each woman receives personal attention from project adviser-advocates. The program also pays for transportation and other child-care costs until the birth. Chicago's Haymarket House even houses its clients during pregnancy and provides follow-up services for as long as three years. Says director Wanda Thomaston of her clients: "It's often their first sober pregnancy. They've never felt their babies move or experienced labor pains."

But it is D.C. General's Maternal and Child Health Project that does the most with the least. Combining a $110,000 grant from the Washington Junior League with other donations, the hospital runs a 10-week support program for patients drawn from its prenatal and drug-abuse wards. The women, many of them homeless, gather weekly for lectures. Each receives a healthy meal and two gifts, one for herself and another for her infant: a blanket, baby clothes, a car seat. "By the time the child is born," says Ivey, "they've assembled a small layette." Volunteer "godparents" help keep their proteges off drugs and attending their doctors' appointments.

The idea that such a modest curriculum would actually untangle the web of misfortune and bad habits leading to abandonment might seem implausible were it not for the program's success rate. Of 200 women who have attended since the Washington program's inception, not one has abandoned her child. As Angela Holland testifies, "They taught me how to get my life back together again."

Holland began doing drugs in 1982, at age 17, when her first child, Tracee, was a year old. The young mother's life unraveled; they found themselves living in an abandoned house with no heat and no gas. Holland signed the baby into foster care. Over the next eight years, while nurturing an escalating habit, she managed to have two more daughters, Rickiyah and Cade. She abandoned them, leaving them with a friend shortly after her boyfriend began dealing and sharing his drugs. "That's when I started thinking about killing myself," she says.

Instead she moved back home to Washington and met a cafeteria worker named Corey Shackleford. He said he loved her but had a nonnegotiable demand: she must get clean. Holland allows herself a small smile. "He'd led a sheltered life," she says. Nonetheless, that November, four months pregnant, she presented herself at D.C. General. "I told them I was a heroin and cocaine user, and sick and tired of getting high," she says. The hospital enrolled her in the maternal-health project.

Over the remainder of her pregnancy, she attended group meetings in the hospital's adolescent playroom, sitting in a circle with other participants, while dietitians, social workers and even an aerobics instructor gave brief presentations and then opened the floor to 1 1/2 hours of lively discussion. Recovering addicts lectured on staying straight. A midwife running the parenting session gave step-by-step instruction on how to dress a child in a snowsuit to 30 young women, many of whom had never had a snowsuit of their own. "I learned how to feed my children -- how to fix a healthy meal and not feed them hot dogs and beans all the time," says Holland. "I learned you don't have to spank them; you can just talk to them." A woman named Michelle Nielsen became her mentor. "I'd take her to the store or to a prenatal class," says Nielsen. "We talked a lot about God and church."

After a particularly difficult Christmas that year, Holland became discouraged. "I started thinking, 'What if my family doesn't want to be bothered with me?' " She didn't like the weight she was gaining without the drugs that kept her thin. But she managed to keep faith, and on Valentine's Day she and Corey were married. In April she gave birth to a drug-free daughter. In June she regained custody of her first three children. Her current situation is not all roses. "Sometimes I want to pull my hair out," she says. "Housing is really difficult for us. But I wouldn't change nothing. I've never felt this kind of love before. I have a life ahead of me and four beautiful girls who depend on me."

There are those who doubt that the D.C. General program alone is sufficient to keep such children out of the foster-care system in the long run. One skeptic is Dr. Sidney Jones, the hospital's chief of obstetrics and gynecology. "The idea of a three-month outpatient program is a joke," he says. "I want money for a house where these women can live for a year." Donna Carson, founder of the Atlanta program, agrees: "A lot of mothers will abandon their babies after they get home because their life isn't working. They need long-term support."

Given the fiscal and social costs of institutionalizing an underclass from cradle to grave, it may be worth calculating the cost of such support. For now, however, there is a symbolic triumph in preventing children from being written off the moment their umbilical cords are cut. And something more than symbolism is occurring in Holland's apartment in Washington's dangerous Northeast neighborhood. A crib stands by the front door; its tenant is holding out her little arms and smiling widely, eyes as big as chestnuts. Holland scoops her up. "I love being a mother now," she says. In her mother's arms, Courtney Rosia-Lee Holland laughs delightedly.

With reporting by Ann Blackman/Washington