They come from countries of unrelenting poverty, oppression, war, and violence. They come to escape all of that with parents, relatives, friends, or alone. They walk miles and miles, day after day, hungry, thirsty, afraid, exhausted. As a recent report in The New York Times revealed the number of migrant children crossing the U.S. border from the south has “soared” for several reasons, including declining situations in Latin American countries along with pandemic induced migration, and the election of President Biden. Last year the influx of migrant children rose to 130,000. That’s three times higher than five years ago.

With this influx of unaccompanied children, child employment has reached Dickensian levels and conditions in most parts of the U.S. Another New York Times article illuminated the reality of this exploitation. One teenage worker “stuffed a sealed plastic bag of cereal into a passing carton. It could be dangerous work, with fast-moving pulleys and gears that had torn off fingers and ripped open a woman’s scalp.” That factory “was full of underage workers … spending late hours bent over hazardous machinery.” In other places kids work in slaughterhouses, wood sawing businesses, or tend giant ovens making granola bars and other snack foods.

According to the Times report, this kind of child labor is part of a “new economy of exploitation,” in which migrant youth constitute a “shadow work force that extends across industries in every state.” This new labor force has been growing, particularly in the last two years, and it’s all in violation of child labor laws. In addition to the work in plants and factories, children wash dishes and deliver meals in various venues. They help build vacation homes, harvest crops, and work as hotel maids, usually at night, after trying to stay awake in school during the day, if the families they stay with actually send them to school as mandated.

Often these children are housed with adults they don’t know. These “sponsors” often exploit the kids, pressuring them to earn money to help with expenses, or payoff smugglers who have helped place the children with them. Oversight and monitoring of these housing situations are often ignored, even though they are mandated. As one caseworker told the Times, “It’s getting to be a business for some of the sponsors.” Schools, businesses, workers in federal agencies, and law enforcement are guilty of “willful ignorance,” as the Times reporter put it.

Child trafficking is another related issue. Anti-trafficking legislation exists in the U.S. but is inadequately adhered to, and made more difficult because of the growing number of children coming across the border, often with worrying debt to pay off. According to the Times report, concerns about unaccompanied minors at the Department of Health and Human Services Office of Refugee Resettlement began to grow two years ago when labor trafficking began growing, exacerbated by the inappropriately quick release of children from detention centers rather than maintaining a focus on preventing unsafe releases.

Child marriage is also something we should be concerned about in this country. According to Equality Now, shocking as it may seem, here in the U.S. child marriage, which occurs when one or both parties to a marriage are under 18 years of age, is legal in 43 states, but 20 U.S. states do not require any minimum age for marriage, if there is parental consent or a judicial waiver.

A human rights violation, “child marriage legitimizes abuse and denies girls’ autonomy. When young girls are forced to marry, they are essentially subject to state-sanctioned rape and are at risk of increased domestic violence, forced pregnancy, and negative health consequences, while being denied education and economic opportunity.” Equality Now explains. Yet, nearly 300,000 female children were married in the U.S. between 2000 and 2018, most of them to much older men. And in some states, child marriage is considered a valid defense to statutory rape.

Child abuse doesn’t stop there in this country. It starts with our inability to end the continuing brutality of gun violence that is the biggest killer of children and teenagers in America. It begs the question, how much do we really care about children when rightwing politicians and the people who vote for them support so-called leaders’ refusal to fund daycare, food programs, and healthcare for children in need, or parental leave so that infants are safe and bonding with their parents? How can we claim to care about children of all ages and ethnicities when Republican legislators try to slash Medicaid, and the Affordable Care Act, deny healthcare to trans kids and mess with the child tax credit program and the Supplemental Nutrition Assistance Program known as SNAP?

It's abundantly clear that all children in this country are in serious trouble, physically and emotionally, and that a sizeable swath of Americans in high and not so high places don’t seem to care and are willing to put future generations in jeopardy – all of which raises the real question:

How is it we go on allowing children to suffer (and die), and still delude ourselves that our country is exceptional?

Perhaps it is, but sadly in is so many wrong ways. Just ask the children.

# # #

Having just witnessed another birth, I’ve been reflecting once more on why I became a volunteer doula and what the work means to me.

I’m a baby freak, plain and simple. As a young candy-striper I routinely snuck into the pediatrics ward so I could rock sick kids. While my high school friends dated, I babysat. If I hadn’t been a product of the fifties, I might have considered becoming a obstetrician or a midwife. Instead I followed the path that most girls my age did: I went to college for a liberal arts degree and then became a secretary -- a medical secretary.

My real career began when I became program director in 1979 for the National Women’s Health Network, a Washington, D.C.-based education and advocacy organization dedicated to humane, holistic, evidence-based, feminist approaches to women’s health care. In 1985 I went to Nairobi for the final international conference of the United Nations Decade for Women (1975-1985). Inspired by that amazing event and armed with a master’s degree in health communication, I began working internationally on behalf of women and children, always trying to bring a gender lens to the table.

In the midst of all this, I gave birth twice. My children were born in the seventies as the women’s health movement, and individual women, were beginning to advocate for natural childbirth and to resist the traumas of overly-medicalized birth experiences. We took Lamaze classes, learned about nursing, expected dads to be active in our deliveries. I was lucky: not only were my labors quick and unremarkable, but the small community hospital where I delivered was sympathetic to the changes taking place in birthing. There were no monitors, no drugs “to take the edge off” if you didn’t want them, no enemas, no shaving, and no macho-docs (although I couldn’t talk my doctor out of the episiotomy). I labored with my nurse and my husband and when the time came to push, I watched my babies come into this world in total awe of what had just happened and what I had done.

Several years ago, I learned that my local hospital had a volunteer doula program. Signing up was a no-brainer and I’ve now had the honor of supporting dozens of women and their partners as they’ve done the hard work of delivering a baby. Not one of them has failed to say afterwards, “I couldn’t have done it without you!” (They could, but I’m glad to have eased their experience.)

One of the early births I attended stands out in my mind. It was a first pregnancy and the mom labored stoically for thirty-six hours, pushing for five, before her son was born. As the hours passed, I held her hand, wet her lips, wiped strands of matted hair from her eyes, rubbed her back. “You can do this,” I whispered in her ear when she grew doubtful. “You’re doing a magnificent job! Soon your baby will be born.” As the baby finally crowned, wet, dark hair pressing urgently against her, I held the mother’s leg in my arm, her hand clenching my free wrist as she cried out with that guttural groan of a woman pushing her child to life outside the womb. And suddenly, there he was, head emerging, wet and pinking up even as his perfect little body swam into being. Later, swaddled and suckling at his mother’s breast, his father, eyes wet, whispered across the bed to me, “Women’s bodies are so miraculous!”

“Yes,” I said, my own eyes filling, “Miraculous.” Always miraculous, no matter how many times you give witness, or weep yourself to see a woman giving birth.

Doula supported childbirth has been proven to reduce the incidence of c-sections, shorten the length of labor, reduce the number of medicated births, increase breastfeeding and provide higher satisfaction for mothers regarding their birth experience. As one pediatrician put it, we are “the descendants of those millions of women who gathered at bedsides around the world” to help women through labor and delivery. “Some day we may again reach a point where women rely on the traditional circle of birth-experienced [women] to ease them through childbirth. … Until then, skilled, compassionate doulas will ably stand in for them.”

That is why I feel privileged to do this voluntary work. It is simply an honor to give witness to birth, and to offer as many women as possible the opportunity to have a birth that is supported, memorable, and full of joy.