Child Rearing Practices Amongst Brothel-based Commercial Sex Workers.

Introduction

Research on sex workers has concentrated on sexual health, rather than on the broader concept of reproductive and child health. The studies and reports on commercial sex workers as a group have usually focused on their background, plight and profession.(1–3) The interventions for this group are aimed at prevention of spread of human immunodeficiency virus (HIV) and sexual transmitted diseases (STDs)(4–6) and a few, for empowerment of women.(78) Many women who engage in sex work, experience pregnancies and become mothers. Unfortunately, very few research studies have examined the challenges faced by the sex workers in raising their children.(9–11) Considering the fact that they are working women with peculiar working patterns and stigma of their profession, this study describes the breastfeeding practices and child placement options chosen for their children by brothel-based commercial sex workers in an Indian city.

Materials and Methods

A cross-sectional descriptive study was conducted in the year 2007 in the brothels of Mumbai city, India. One of the localities of the red light area was selected, in consultation with a local non-governmental organization (NGO). The peer workers enumerated all the brothels in the locality. Out of these, 30 were selected by a simple random sampling method. The data was collected using quantitative methodology. The interviews were conducted in the office of a local NGO located in the red light area, ensuring privacy and confidentiality, after an oral informed consent was taken. Three women from each of the selected brothels were contacted for collecting preliminary data, using a pretested structured questionnaire. The brothel-based sex workers, who had born children in sex work, were selected for in-depth interviews.

Results

A total of 90 women were contacted for the interviews out of which 87 agreed to participate in the study. They included women from Nepal (51) and “others” from states like Maharashtra and Andhra Pradesh (36). 39 (44.84%) women were in the age group of 21–29 years followed by 34 (39.08%) in age group of 31–39 years. 59 (67.82%) women were illiterate [Table 1].

Table 1

Socio-demographic characteristics of sex workers

Table 2 shows that out of the 49 babies born in sex work, 23 (46.94%) children had been breast-fed for 1 year or more than 1 year and 9 (18.37%) were never breast-fed.

Table 2

Duration of breast feeding in children born in sex work

Table 3 shows that out of the 38 children born prior to entry into sex work, 13 (34.21%) were sent to hostels and 25 (65.79%) were with their families in the native villages. Out of the 49 children born in sex work, 17 (34.69%) children were being raised in the brothel. The children were kept in the brothels up to 5 years of age. Some of the local NGOs were running a residential school for the children of the sex workers. The key informants reported that the women faced difficulties in getting school admissions for their children, e.g., non-availability of birth certificate, residential address proof, father's name, etc.

Table 3

Child placement options

Discussion

The commercial sex workers conceived and decided to have a child under different circumstances. A few had children due to ignorance about contraceptives and MTP, but many decide to continue the pregnancy, as they wanted children. Some of them develop a fixed relationship with a partner, but eventually all have to function as single parents for their children. Such relationships have been described in other studies, which have focused on condom use in the sex workers.(1112) These were men who began as clients and then formed long-term relationships. Women need these companions for emotional and practical reasons and are tied to these relationships. However, in a majority of the cases, such relationships were noted to last for a few years, after which the male partner left the women. Thus, as mothers, the brothel-based commercial sex workers were functioning as single parents, shouldering the responsibility of providing financial support, decision- making, and providing care to her children.

All the sex workers were immigrants to the city and the kind of family support they received, varied according to their background. A high proportion of children in our study were in the native place or in institutions. This can be attributed to the fact that a local NGO was running a residential school for these children. In addition, the peer workers along with another NGO based in the red light area, were motivating and helping the sex workers get the children admitted to schools.

The peculiar working schedule of the sex worker, in which she is busy by night and tired in the daytime, posed problems for breast feeding the child. Day care centers and night shelters should be made available for children being raised in the brothels. The stigma of being a sex worker makes it invariable for them to send the children to an institution, which is an attempt to keep the children away from the brothel environment and also to hide their identity as a sex worker. Admissions in residential schools along with special rehabilitation centers will help the children to integrate with the mainstream society in the future. The role of non-governmental organizations and local peers was found to be very important in the rehabilitation of the children of sex workers. The commercial sex workers dream of a bright future for their children. They should be supported and guided to make this dream a reality, at all costs.