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Poverty's Legacy - Fragile Families, Vulnerable Babies

By Marilyn GardnerStaff writer of The Christian Science Monitor / December 18, 1989


In the ancient city of London, on a certain autumn day in the second quarter of the 16th century, a boy was born to a poor family of the name of Canty, who did not want him. On the same day another English child was born to a rich family of the name of Tudor, who did want him.... There was no talk in all of England but of the new baby, Edward Tudor, Prince of Wales, who lay lapped in silks and satins ... But there was no talk about the other baby, Tom Canty, lapped in his poor rags, except among the family of paupers whom he had just come to trouble with his presence. From ``The Prince and the Pauper,'' by Mark Twain

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IN one corner of the neonatal intensive care unit at Broward General Hospital, a tiny 13-day-old baby sleeps in an incubator that gently rises and falls, reminding him to breathe. Born three months prematurely to a cocaine-addicted mother who received no prenatal care, he weighed just 1 lb., 14 ounces at birth.

Doctors say he is probably blind and suffers from seizures, among other grave complications. He will spend between six and nine months in this ward, at a cost of $1,000 to $1,500 a day.

After that, the infant faces an uncertain future. ``Nobody wants him,'' explains Dr. Brian Udell, director of the unit.

In another corner of the 63-bed ward, doctors are preparing a four-week-old boy for surgery. He is the fourth cocaine baby his mother has delivered in this hospital and the only one to live.

Not far away, a nurse is dressing another infant, a four-pound boy born three weeks ago, who is being discharged today. His mother, who is 15, also has a 10-month-old baby at home.

``He's going to be another toy for her to play with,'' the nurse says sadly. ``It's pointless to try to teach her about parenting. She's not going to do it when she gets home. Her mother will.''

Day after day, in high-tech neonatal intensive care units across the country, heart-rending dramas like these are being played out involving the nation's youngest, most vulnerable citizens. These are babies born on the most unlevel of playing fields. Call them ``welfare babies,'' ``crack babies,'' ``at-risk babies,'' or ``deficit babies'' - by whatever term, they constitute a new ``bio-underclass'' of infants who are disadvantaged almost from the moment of conception.

Like the 16th-century England Mark Twain portrays in ``The Prince and the Pauper,'' late-20th-century America represents a land of stark contrast for babies. At one extreme are the babies of affluence - newborn ``princes'' and ``princesses.'' Planned for and wanted, they are monitored in the womb by sophisticated medical technology, then pampered after birth with $800 imported cribs, $300 strollers, infant gyms, and designer baby clothes.

At the other extreme are the babies of poverty - under-cared-for, often unwanted ``paupers'' who may be born too early and too small. So desperate is their plight that the '80s phrase, the ``feminization of poverty,'' is now joined by another closely related term, the ``infantization of poverty.''

One-fifth of all American children, and 45 percent of black children, live in homes below the federal poverty level, which currently stands at $9,435 for a family of three. Another sobering statistic: An estimated 375,000 babies have been born to substance-abusing mothers in 1989.

In addition, 470,000 of the 4 million babies born this year are the children of teenage mothers, most of them without husbands, job skills, or perhaps even a home. Last year United States taxpayers paid nearly $20 billion to support families begun with a birth to a teenager.

One of those dependent young mothers, 18-year-old Tina, typifies the problems many children having children face. Early in her pregnancy, she dropped out of school and moved from Indiana to Fort Lauderdale with her boyfriend, Steve. When she went into labor she simply showed up at the emergency room of Broward General Medical Center, which accepts indigent patients, and said, ``I'm here. Help me.''

Her daughter, Autumn, was born full-term and healthy. But within weeks Tina and Steve found themselves moving out of a relative's home and knocking on another door for help, this time at Fort Lauderdale's Covenant House, a 104-bed shelter for homeless teenagers.

``I didn't expect to become a parent as soon as we did,'' admits Tina (Covenant House policy prohibits the use of last names). ``After it happens you think about birth control. But we didn't once think about abortion or adoption.''