An Abusive Relationship

     A childhood friend was in an abusive relationship as a teenager. Obviously, this was not her early childhood but since teenagers are still children, it had a significant impact on her identity as an adult. She began dating a man much older than her and eventually moved in with him. Much too young to be in a serious relationship, she did not realize the trap she was walking into. In short time, he began to throw punches, push, shove, and rape her.  One night he beat her and put her in the hospital.  She tried to commit suicide while in the hospital and was placed on a three day hold.  She moved back home and began a medication regimen that left her tired and dazed.  She pressed charges and he was placed in jail. Unfortunately, he was released and beat his new fiance with an electric guitar on their wedding night until he nearly killed her.

     How has this affected my friend's adult life more than 15 years later? She still talks about the beatings she received, the fear she has of running into him in our town, and the PTSD she experiences when her now husband raises his voice or hints at being upset.  Although her husband is an amazing, even tempered man, he still has emotions just as we all do.  However, he knows to be careful about any sudden physical movement, yelling, or getting angry in her presence.  It sends her into a physical and emotional spiral of crying and self doubt. She has issues with lacking confidence and questions her own ability as a mother and wife quite often. Because this boyfriend also cheated on her, she has an underlying fear of that happening again. As a result, she has learned to be very honest with her husband if she thinks a friendship is getting out of hand. 

     The adult she is today would never consider entering into that kind of relationship now. She has become a strong, wise woman. She works in social services, and I often wonder if this experience is what makes her so passionate and great at her job.  She is able to connect with mothers and wives that are abused. She shares a true empathy and gives them hope for what the can become.

                               

                               Violence in Juarez, Mexico and Children's Health

     Juarez was once (2010) considered the murder capitol of the world for its excessively high rate of deaths related to drug violence.  Since then, children's mental and physical health has been a concern.  A comparison study between Juarez (3000 murders in a year) and El Paso (5 murders in a year) was conducted on the two neighboring cities.  Child behavioral checklists were completed by parents for over 600 children.  The children in Mexico had a higher prevalence of aggression, depression, anxiety, withdrawal, and attention deficit disorder. Their rates were three times higher than those in El Paso.  The behavioral issues of the children in Juarez closely aligned with the behaviors of children with brain injuries and those exposed to drug use.  Lanier (2015) also notes that Mexico does not censor violent images such as mutilation on the news. Even children not exposed directly to violence are indirectly exposed through media.  Lanier (2015) writes that "behavior issues like aggression may become an issue as the chidlren grow older" (https://www.sciencedaily .com/releases /2015/12/ 151211145100.htm).  

   
                                      
                                      12 year old killed on drug related crossfire

     The majority of the images were too gruesome to upload. I had to stop looking after only a few minutes.  Children are exposed to mutilated and dismembered torsos, decapitated heads,and bodies strewn on the sidewalks.  As you can see from the map, this is not happening across the world somewhere. This is happening just minutes from the United States.  So, here is my pro immigration stance: Rather than build a wall to stop the flood of people into the United States and thereby trapping thousands of innocent children in this torture chamber, we should spend the money on assisting Mexico with cleaning up their streets from the cartel.

                                                                          References

Leiner, Marie. (2015). Science Daily. Violence in mexico affected children's mental health.
     Retrieved from: https://www.sciencedaily.com/releases/2015/12/151211145100.htm

Child Maltreatment: A Public Health Concern

Maltreatment of children is a public health issue throughout the world with lasting mental and physical health effects into adulthood.  Merrick and Latzman (2014) write that "child maltreatment has been linked to a variety if short and long term health consequences including poor physical and mental health, changes to brain architecture and development, altered biological factors, reduced cognitive ability and educational achievement, and impaired psycho social functioning" (p. 1). Throughout the article, they point out that child maltreatment due to neglect, physical abuse, and sexual exploitation increase visits to the emergency room, doctor's offices, and clinics. This abuse not only harms the child but places an additional strain on the already overburdened medical care system.

Child maltreatment is also becoming an increasing burden on my school system. We are currently training on providing trauma informed care to our students who have been victims of abuse, neglect, domestic violence, and malnutrition.  These students show decreased emotional control, cognitive delays, and an inability to connect with peers.  There behaviors cause us to seek mental health care and special education services.  Again, this places a burden on an already overwhelmed mental health care system and education system due to an issue that is 100% preventable.

Child sexual exploitation is a growing concern everywhere but especially in India. The India Times published an article in 2007 about the increase in sexual exploitation of children stating that in 88.6% of children were exploited by parents ranging from rape to fondling.  Another article in the same paper published in 2016, recounts incidents of child rape by staff of a group home for children.  One child was infected with HIV at age twelve due to rape from a 58 year old male manager.  Obviously, there is still much progress to be made in India regarding child maltreatment in all areas including sexual exploitation, child labor, physical abuse, and neglect.

Anwar, Tarique. (2016). Sexual exploitation, rapes& abuse. a look inside india's hellish juvenile
     correction homes. The India Times. Retrieved from: http://www.indiatimes.com/news/india/india-      s-hell-holes-sexual-exploitation-forced-lesbianism-and-physical-abuse-children-take-it-all-at-              juvenile-homes-261747.html

Latzmen, N. & Merrick, M. (2014). A public health overview and prevention considerations.
     The online journal of issues in nursing. 19, 1-12. DOI: 10.3912/OIJN.vol19No01Man02.

The Times of India. (2010). Over 53% of children face sexual abuse: survey. Retrieved from
     http://timesofindia.indiatimes.com/india/Over-53-children-face-sexual-abuse-                                      Survey/articleshow/1881344.cms

Birth Experience
The birth of my first son nearly ended in my death. He was fine, but I was not.  The birth of my second son, however, nearly took us both.  Both of my pregnancies were high risk as I had preeclampsia. Doctors were monitoring me the second time because it caught them by surprise the first time. At the first sign of fetal stress, I was placed on bed rest for a month and then placed in the hospital for observation with 8 weeks left to go.  After monitoring my levels, it was decided that an induced labor would be best as my blood pressure had not yet begun to rise but I was showing signs of kidney and liver damage from the pregnancy. They began to prepare for a delivery within 24 hours when his heart rate suddenly dropped.  The room went from calm to chaotic in less then 10 seconds.  I found myself being unplugged and rushed to the operating room while signing a permission form for a c-section all while rolling down the hallway still in bed.  Within 45 minutes of the heart rate drop, my son entered the world.  He didn't cry, and he didn't open his eyes. He had no body fat and weighed only 3 pounds. They immediately wrapped him up, showed me his face, and ran down the hallway to the Neonatal intensive are unit.  Somewhere just outside the operating room doors, he finally gasped for air and let out a scream. He was angry!

The placental pathology report revealed that the placenta had been operating at half capacity for two weeks.  We were told by his pediatrician to consider him to be 10 weeks early rather than 8.  In addition to my physical inability to carry a child to full term (his brother was 5 weeks early), he had been exposed to magnesium sulfate for two days prior to birth as well as the overwhelming stress levels of his mother throughout the pregnancy. His brother is only 15 months older than he is. Do the math: I was pregnant only 7 to 8 months after I had his brother. He was not planned and I was still not fully recovered form my first pregnancy.  It took months for me to figure out I was even pregnant. I was still nursing and had not yet had cycle.  I suspected many times that I was pregnant and took multiple pregnancy tests. My hormone levels were so low, that I did not have a clearly positive test until 3.5 months.  I was told at my first appointment, that I might want to consider an abortion.   That wasn't an option for me.

I chose to share this story with all of you because despite this experience and the struggles we still endure, I do not regret having my son.  His level of autism is low, and he's actually quite entertaining. He is literal and truthful. Anytime I need to go shopping for an outfit for a public appearance, I take him with me.  If it looks terrible, he tells me.  I have watched that child fight and struggle his entire life but he never quits. He could truly care less what other people think of him. He's different but he's amazing.

Development Related to Birth Experience and Prenatal Experiences
      Within his first few weeks at home, it was obvious we had prenatal and birth related trauma to contend with.  He cried all the time, ate constantly, and had a difficult time bonding with me. In addition to what we later discovered was autism, he and I had been separated for several days after his birth making our initial bonding time non existent. Clearly, his birth experience had an impact on his development.  His unhappiness led to frustration and his inability to effectively communicate led to violent anger as he grew older.
      When we register children with our Head Start program, we have parents complete a health assessment. A sizable portion of this assessment is about prenatal healthcare, prenatal drug use, birth weight, prenatal nutrition, and the delivery method.  Several years ago, my teacher's assistant and I began to notice odd behaviors in our students after just a few weeks of school.  The new student behaviors should have passed. We noticed and inability to grasp the rules, the routine, to maintain self control. We also noticed high levels of anxiety in certain children despite our peaceful setting.  She walked straight to the file cabinet and pulled the health assessments. Over the course of the next two hours, she charted similarities and discovered that over half of our students had prenatal substance exposure ranging from alcohol to heroin to marijuana.  Needless to say, we changed our approach, decreased our expectations, and extended our timeline for learning.

Puerto Rico
Birth in Puerto Rico has some slight differences despite Puerto Rico being a United States territory. Mothers report receiving an ultra sound at every appointment to monitor fetal development.  They also report that most obstetricians are male and female obstetricians can be requested.  Mid wives and doulas are not as common in Puerto Rico as in the United States.  Regulation of midwives is still an area that many believe needs improvement. Currently, there is only one regulated birth setting and that is solely a clinical one in a hospital.  Fertility rates have been on the decline for many years. In 2003, the average woman was estimated to have 1.9 children. In 2013, this number was down to 1.3 (Krogstead, Lopez, Desilver, 2013, p. 4).  Krogstead et al. (2013), claims that this is due to the increase in people moving to the United States and delivering here.  Currently, however, Puerto Rico and the United States only differ in 5 births per one thousand people.

                                   

References:
Krogstad, J. Lopez, M. Desilver, D. (2013). Puerto Rico's losses are not just economic, but in people         too. Retrieved from http://www.pewresearch.org/fact-tank/2015/07/01/puerto-ricos-losses-are-             not-just-economic-but-in-people-too/