Most of our mothers who use cocaine tend to be older, at least older as far as mothers of newborns go. It's not surprising, too, that they often don't get much prenatal care, given their chaotic lives. But the part that puzzled me was why they so often had so many pregnancies. I know that some of these women will earn money for drugs by prostitution, either overt prostitution or by attaching themselves to a man who provides for them even though they don't really care for him. You would think, though, that it would be to their advantage to use birth control or even get their tubes tied, that they would do better in prostitution in a non-pregnant state. Then one day an obstetrician who has worked for years in our urban area explained to me that a woman's value on the street was higher if she was fertile, was lessened if she could not get pregnant.
I don't know if that's true or not. It has the ring of urban myth. Maybe it's just their chaotic lifestyles that also explains their frequent pregnancies. But truth can be stranger than fiction, so it could very well be true or at least partly be based in fact.
I've written before in a post that some people get angry at mothers who use drugs during pregnancy, but that doesn't do any good, except for letting the miffed health care worker blow off some steam. Instead, we should recognize that the birth of a baby can be a time when a mother might have incentive to change her life, to make things better for her baby, and we should capitalize on that by trying to get her into rehab. It seems like a small step compared to the problem of women who remain fertile to increase their value, but hey, it's at least something.