Did DHS pressure teen to get abortion?

By REGINA MEDINA, Philadelphia Daily News
May. 04, 2010

A DEPARTMENT OF Human Services caseworker pressured a pregnant Mayfair teenager to undergo a late-term abortion by threatening to take away either her toddler or her unborn baby if she had the child, according to the teen's foster mother.

The alleged strong-arm tactic happened one day after DHS learned of the pregnancy, when the girl was about 22 weeks pregnant, according to her foster mother and the girl's social worker, Marisol Rivera.

The foster mother did not want to be identified in order to protect the girl's identity.

The Daily News also learned that:

* DHS got a Family Court judge's order allowing it to take the girl for an abortion, after the girl's birth mother refused to approve the procedure.

* By the time DHS arranged for the abortion - in March - the girl was 24 weeks pregnant. She had to undergo the procedure in New Jersey because abortions in Pennsylvania are illegal at 24 weeks.

* Although it is DHS policy that a DHS worker accompany any minor who has a court-ordered medical procedure, this did not happen on the girl's first attempt to have the abortion. That attempt failed when the clinic wouldn't accept her Medicaid card and wanted cash, according to the foster mother. A DHS worker did accompany the girl on a later, successful, attempt.

* Rivera, the girl's social worker, said that she was fired by Concilio, which subcontracted with DHS to provide care, after she initially refused to accompany the teen for the abortion.

"They hired me to work in child protection, not to kill children," Rivera told the Daily News.

DHS officials said that they could not discuss the case because of medical-privacy laws. Attempts to talk to the teenager were unsuccessful.

But a source familiar with the case insisted that the girl was not coerced and that her foster mother, whose first language is Spanish, did not understand the conversation between the girl and the DHS worker, Cynthia Brown.

Brown declined to comment.

Abortions are a little-known aspect of DHS's oversight of children in its custody.

Donald F. Schwarz, the city's deputy mayor for Health and Opportunity, who oversees DHS, said that the agency "is supposed to take a neutral position and not supposed to be involved in the decision making" regarding an abortion.

Between September 2006 and March 31, Schwarz said, 335 minors under DHS care became pregnant. Of those, 119 resulted in abortions. Of those abortions, 54 were done by judge's order.

Eight of the abortions were performed out of state, Schwarz said.

Although federal and state law forbid the use of federal or state money for abortions, and DHS is a recipient of state and federal aid, that money is not used to pay for abortions, Schwarz said.

He said that money only from the city budget is used to pay for the procedures.

Art Caplan, director of the Center of Bioethics at the University of Pennsylvania, said that if the foster mother's allegations are true, the DHS worker was acting unethically.

"You can't or shouldn't be threatening to break up a family depending upon whether somebody gets an abortion or not," Caplan said. "That is . . . unethical practice, it's not even common sense."

Richard Wexler, executive director of the National Coalition for Child Protection Reform, said: "If DHS's behavior is as described, it is shameful and inexcusable. . . . Sadly, this is not surprising . . . . This kind of bungling, this is not unusual in child-welfare systems. Especially in Philadelphia."

Short-lived joy

The pregnant teen was excited about having the baby, her foster mother said. She learned that she was carrying a boy and told her 1-year-old daughter that she was going to have a little brother. She even talked about a name for the baby.

The teen's birth mother, who wanted to be identified only as Deborah M., also said that her daughter was excited to have a baby.

"Someone who went to go get an ultrasound, [found] out it's a boy, they give the boy a name, that's somebody who wants to have that baby," Deborah M. said. "But the next thing I know, she's going for the abortion."

The teen's foster mother - who is fluent in Spanish and understands basic English - said that she was present when DHS worker Brown discussed the pregnancy with the teen in the living room of her home.

The conversation occurred the day after the girl's ultrasound, the foster mother said.

She said that Brown told the pregnant teenager that DHS would separate her children if she had the second child.

"She said that if she decided to have the infant she wasn't going to let her have both babies, that I know [despite the language barrier]," the foster mother said. "They wouldn't be together."

During the conversation, Brown was "upset" and "agitated," the foster mother said, and the teen began to cry.

In an interview conducted in Spanish, the foster mother said that she had been listening to the two from the top of the stairs, but rushed down when the teen began crying.

She asked Brown, "Is there a problem?"

"Of course, there is a problem," the foster mother said Brown told her. "This girl is 16 years old, she's in school, she already has a baby. Yes, there is a problem."

By the next day, the teen was determined to get an abortion, the foster mother said.

Rivera, the girl's social worker, said, "Ever since DHS went there [to the foster home], the only alternative that she saw was abortion."

Deborah M., the girl's birth mother, said that she believed the foster mother's allegations because she'd witnessed Brown bullying her daughter once before.

Brown had discovered that the teen had not been taking her child to day care.

Brown, she said, rushed up close to the teen's face and said, "If you don't put your baby in day care, I'm gonna take your baby."

Deborah M. said that she then ordered Brown out of her home, and that she left.

Caring for pregnancies

Schwarz said that when DHS is alerted to a child's pregnancy, "the youth and her caseworker discuss the [youth's] plans regarding her pregnancy."

DHS offers counseling, family planning and other pregnancy-related services such as prenatal care, abortion and adoption, he said.

Rivera said that when she telephoned Brown with news that the teen was pregnant, the DHS worker was "shocked."

"Oh, my God, but that girl has to study," Rivera recalled Brown saying.

The teen's birth mother and the foster mother said that they separately heard conversations between Brown and the teen where the word "abortion" was mentioned.

Both said that they heard no mention of other alternatives, they told the Daily News.

Rivera said that after the teen's confrontation with Brown, she counseled the girl about her pregnancy, including alternatives such as adoption.

Rivera said that she and Concilio's Family Services Supervisor, Zenaida Maravi, told the teen that she could keep both children if she carried the pregnancy to term.

The teen remained silent to their comments, Rivera said.

Getting the abortion

On March 10, the day after DHS secured the court order for the abortion, Concilio supervisor Maravi told the teen's foster mother that she must take the girl to an abortion clinic. The foster mother, who arranged for a relative to drive them, said that she was reluctant to go, believing that the girl was too far along for the procedure.

But when they arrived at the clinic, which the foster mother could not identify, it would not accept the teen's Medicaid card as payment, the foster mother said.

Six days later, on March 16, Brown, the DHS caseworker, took the teen to the Cherry Hill Women's Center without alerting the pregnant teen's foster mother or Rivera, the women said.

Rivera and the foster mother believed the clinic performed an abortion. A common procedure for late-term abortions is dilation and extraction. The procedure usually takes two or three days. On the first day, doctors inject a substance into the fetus to stop its heart as well and begin the dilation process. The woman typically goes home and returns the next day so that the fetus can be extracted.

The pregnant teen had left for school late that morning, out of character for the girl, the foster mother said. By 7 p.m., the teenager hadn't arrived home and the foster mother called Rivera in a panic. The social worker told her to call police by 10 p.m. if she wasn't home by then.

The girl arrived home around 8:30 p.m.

"What happened?" the foster mother asked her.

"The baby is dead," the teen answered. The teen told her that Brown had taken her out of school to get an abortion in New Jersey.

The next day, Concilio provided a van to take the girl back to the clinic for the second day of the procedure, according to Rivera.

Rivera initially refused to accompany the teen, but when she learned that the first step of the procedure had already been performed, she relented.

"That baby had to be taken out of her," Rivera said. "It couldn't stay in there much longer. It was against my will, but I had no other option. Instead of one dying, two were going to die [if the procedure was not completed]."

Rivera is fired

Rivera said that when she initially refused to take the teen to the clinic, Maravi, her supervisor,threatened to fire her for insubordination.

Rivera wrote a memo to Concilio's human-relations director complaining about the threat.

She was fired on April 14 for "deficiencies in your job performance" in a letter signed by Joanna Otero-Cruz, Concilio's executive director.

Rivera says she believes that she was fired for complaining about her supervisor's threat.

"The decision to terminate the life of the child had been made by another, I had nothing to do with it," Rivera told the Daily News. "I told [Maravi] that my religious beliefs, my moral beliefs would not allow me to participate in an action like this one. And at no moment when Concilio hired me did they tell me that I would participate in that."

Rivera and other Concilio employees said that the agency seemed wary of involvement in the teen's late-term abortion.

At a March 12 meeting of Concilio's foster-care staff, Maravi told the group, "Concilio will not become involved in that situation. DHS will resolve it," Rivera said.

But the following week, two Concilio employees and a Concilio van were used to take the teen to the abortion clinic.

Maravi said she could not discuss the case. Otero-Cruz did not return a phone call.