The experience of motherhood among women in prostitution with drug addiction

Motherhood is both a personal and a universal experience (Rich, 1976), close to every human being, as all of us, women and men, parents and non-parents alike, emerged from a woman’s womb. There is broad consensus in professional literature that a consistently responsive and nurturing maternal relationship, which adequately meets the child’s needs, is crucial for healthy development, and that the absence of such care is associated with numerous mental health difficulties. The psychoanalyst Winnicott (1964) coined the term “good   enough mother” to describe the gap between the fantasy of ideal, flawless motherhood and the limitations of reality. However, this fantasy has not only persisted but continues to function as an enduring wish and a resilient cultural myth. Its persistence exacts a particularly heavy toll on women who are far removed from this unattainable ideal of motherhood. Social perceptions that view prostitution, substance addiction, and motherhood as mutually exclusive realities as if, the existence of one negates the other intensify the mechanisms of oppression directed at mothers in prostitution who struggle with drug addiction. This neglect is not limited to society at large; it also permeates therapeutic and research domains. Systematic reviews over an extended period have identified only a limited number of studies in this field, and only a minority of them have employed qualitative methodologies.

Gur (2008b) describes the reciprocal relations among sexual abuse, drug addiction, and prostitution as a circular connection that she terms a "death trap". It originates in childhood sexual abuse, which serves as a direct mediator for entry into prostitution due to the immediate psychological harm that leads to emotional dissociation, an adaptation deemed necessary for engaging in prostitution. Drugs, in turn, function as a means of numbing the pain caused by prostitution, while prostitution becomes a means of obtaining drugs.

To understand the depth of oppression experienced by women in prostitution with addiction, Crenshaw (1989), and subsequently Krumer-Nevo and Komem (2012), propose examining the interplay among the various marginalized positions in their lives such as gender, poverty, childhood trauma and ongoing trauma, and single motherhood and how these intersect to produce unique forms of marginality whose impact exceeds the sum of their parts (Krumer-Nevo, 2006).

This study seeks to illuminate the experience of motherhood among women coping with prostitution and drug addiction. The research is grounded in a critical feminist-qualitative approach that engages in in-depth dialogue with women living in painful circumstances, who contend with social marginalization and exclusion and who are subject to significant research neglect as well as social and professional stigmatization. To this end, 13 semi-structured in-depth interviews were conducted, focusing on the experience of motherhood, its expressions, and the ways in which it unfolds in their lives.

The findings indicate four central themes. The first addresses the impact of childhood trauma on the participants’ present lives, including the conceptualization of prostitution and substance use as a continuation of early harm, consistent with existing literature that links sexual victimization within the family of origin and early childhood to prostitution and drug use.

The second, third, and fourth themes describe the emotional, caregiving, and perceptual dimensions of maternal experience. On the emotional level, a powerful experience of maternal love toward their children emerged. This love is often intertwined with deep concern for their children’s future, which for many constitutes the very meaning of their lives. Additionally, feelings of self-disgust associated with involvement in prostitution were prevalent, as well as a high incidence of guilt among mothers who continued to use drugs after giving birth. However, in a way that challenges existing literature, most participants ceased drug use during pregnancy, an important finding that significantly decouples the traditional association between prostitution and addiction.

Regarding the caregiving experience, prostitution appeared as a functional economic survival strategy to finance children’s needs, accompanied by a conscious choice of forms of prostitution that allowed for greater parental presence. Participants also described protective patterns aimed at preventing their children from experiencing the harm they themselves endured, as well as close and friendly relationships with their children. Alongside this, separate findings emerged among participants who continued using drugs after childbirth, describing experiences of emotional detachment, difficulty perceiving their children’s emotional and physical needs, and challenges in responding to them.

On the perceptual level, the "good mother" is depicted as one who recognizes her children’s needs and responds to them, and most participants viewed themselves in this way. At the same time, they were acutely aware of society’s negative perceptions of them and of the judgmental attitudes of institutional authorities, which function as barriers to accessing support from agencies responsible for assistance.

The discussion chapter elaborates on understanding prostitution among mothers as a distinct and unique phenomenon, different from how prostitution is commonly portrayed in literature. In this context, motherhood emerges as a motivational factor for ceasing drug use, whereas prostitution becomes functional for financing the child’s needs and protecting them as part of fulfilling maternal responsibility, within a reality of constrained opportunities in which the choice is often between one bad option and another. Motherhood, in effect, disrupts the dependency link between prostitution and addiction that is prevalent in professional literature. Furthermore, the discussion highlights the profound impact of oppressive power structures in society, welfare systems, and legal institutions on constructing these women as "unfit" mothers, alongside the exposure of forms of quiet agency and moral resistance that develop within this reality.

The significance and contribution of this study lie primarily in giving voice to the women themselves, the participants whose life stories are marked by harm, exclusion, and silencing. The research deepens understanding of motherhood in the context of prostitution and drug addiction as a distinct phenomenon and underscores the importance of "knowledge from life" (Krumer-Nevo, 2000) for comprehending it and for developing appropriate interventions.