When the car skidded to a stop at the emergency room entrance, the labor pains were every two minutes, and there wasn’t much time.

He squeezed her hand and reminded her to breathe. She screamed until the epidural took effect.

Everything had built toward this moment, all the hours the couple spent reading the encyclopedia to the swollen belly, all the time crocheting little hats and blankets, all the searching for the baby’s perfect first outfit, all the classes and careful study.

Diana Multari, 26, and Will McBryar, 24, wanted to be the perfect parents for the girl they nicknamed “Little.”

Life had been messy. She had a traumatic history. He had a criminal record. But their mistakes were in the past. When they came home with their baby they would start again, they told themselves, this time as a family.

But plans changed.

Hospital records describe what happened that day at Erlanger hospital like this: The baby tested positive for amphetamine. A nurse was concerned about domestic issues. The mother complained of depression and said she was afraid for herself and her baby and that she was having suicidal thoughts. The mother said she didn’t know if she could care for her baby. A staff member stayed with the mother overnight to monitor her. The next morning a member of the hospital’s crisis team evaluated the mother and determined that she did not need treatment. She was not a threat to herself or her baby.

But before Multari was discharged, a Georgia child welfare worker appeared at the hospital with her own questions. She had been told about the drugs in the baby’s system and Multari’s behavior after the birth.

“It was reported that the birth mother made comments to the medical staff at Erlanger East that she was not mentally up to caring for the child and that she wanted to commit suicide,” the caseworker later wrote in a report.

Without identifying herself, the parents said, the social worker began interviewing Multari, asking about their parents, their relationship, their health.

“Who are you?” Multari said she asked.

“You best not get defensive,” Multari said the woman responded.

The woman told her that if she cooperated, everything would be fine.

Minutes later, while Multari was nursing the baby, a nurse came and took the newborn away.

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7,898

Children removed from their home in Georgia last year

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291

The number of those children who were less than five days old. Almost all of the cases involve either drugs found in the system at birth or an accusation of neglect.

Source: Georgia Division of Family and Children Services

In her notes, the caseworker, with no medical proof, labeled Multari and McBryar with a slew of psychiatric disorders. Multari was catatonic, with depression, attention deficit disorder and bipolar disorder, she wrote. McBryar was autistic and had intermittent explosive disorder, she wrote. No police report was filed, but she wrote that McBryar was kicked out of the hospital for fighting with a family member, that he previously choked the mother of his child in the hospital. Without going to their house, she said their home looked as if they were hoarders.

They wouldn’t even learn about the accusations until they went to court, forced to defend their parenting without ever being allowed to parent.

We have never hurt our child, they argued. We never even had her in our custody. How can the state take her away?

That was six months ago.

No parent is perfect and no parent is really prepared for how a child will change their life.

But while most parents are given latitude, room for mistakes, room to learn and grow, others like Multari and McBryar, are not.

Parents perceived as having a disability, especially a mental illness, too often aren’t given the same latitude, and national research shows they are easily entangled in state child welfare cases, investigated by caseworkers who misunderstand their conditions and exaggerate their inability to parent.

It is true that some of the most horrific child deaths have been at the hands of the mentally ill. There was the mother who fed her son salt until he died. There was Susan Smith, who buckled her two sons in their car seats then rolled the car into a lake. There was Andrea Yates, who drowned her five children one-by-one in the bathtub because she didn’t want them to go to hell. But mental illness does not equate to murderous intention, experts say. In fact, most of the mentally ill are never violent.

Diagnoses like ADHD, bipolar, depression, postpartum depression and anger issues, are widespread — one in four Americans experience a mental illness in any given year, according to the National Alliance on Mental Illness, and advances in medicine and therapies have dramatically reduced the impact of the severe symptoms associated with mental illness. So a diagnosis shouldn’t bar parenting, says Katy Kaplan, a researcher on parents with psychiatric disabilities.

Still, 36 states, including Georgia, Tennessee and Alabama, cite parents’ disabilities as a reason to terminate parental rights, even when no abuse has taken place.

A spokeswoman for the Georgia Division of Family and Children Services, an agency that has been under fire in recent years and is now the focus of legislation that could require stricter oversight, said the state does not discriminate against parents with disabilities. But she also said the state does not keep track of how many parents lose their rights because of a disability.

A report released by the National Council on Disability said discrimination against parents with disabilities is widespread. While the Americans with Disabilities Act provides wide protection, it has historically not applied to parental rights, which federal officials say should change. Another study published by the American Journal of Psychiatry found that parents with a mental illness are nearly three times more likely to lose custody of their children than parents without a diagnosis.

In Georgia, state intervention has spiked significantly since a series of high-profile child deaths brought media attention and criticism of how Georgia was handling child abuse cases. Gov. Nathan Deal removed the head of the Division of Family and Children Services last summer and has said the state was putting too much emphasis on keeping families together. Since last March, the number of cases investigated has nearly doubled and the number of children in state custody reached 8,862 last year, the highest total since 2009.

Experts say this happens all across the country. Out of fear, caseworkers overcorrect and by doing so run the risk of violating parents’ rights, especially parents who are disabled. It is a careful juggling act, balancing the rights of parents to raise their children with the rights of the child to grow up in a safe home.

But once ensnared in the child welfare system, everyday failures — putting off cleaning the house, fighting with your spouse, losing a job, facing medical troubles — become magnified.

Where you live is judged. Where you work is judged. Your personality and values are judged.

And often the judgment is made in just hours. A state-appointed psychologist, through a few written tests and a brief discussion, forms the recommendations that are sent to a judge who decides the fate of that family.

So it’s that easy. Overnight, Multari and McBryar went from eagerly awaiting the birth of their baby girl to standing in a courtroom as potential child abusers.

When they came before the judge in Murray County, Multari and McBryar had an explanation for everything.

The amphetamine in Multari’s system was from Adderall that her OB-GYN had prescribed during her pregnancy for her ADHD, records show. State law requires hospitals to report infants who are born with illicit drugs in their system and show signs of drug withdrawal, but women who take medications as prescribed by a doctor should not face prosecution, according to the state health department.

Still, Multari was reported.

The depression she felt after the the birth is common, she said. As many as one in seven women suffer from postpartum depression, according to the Journal of the American Medical Association. Plus, the hospital had cleared her after a full evaluation, she explained. In the state report, the caseworker wrote that Multari seemed to be in a catatonic state. But the couple told the judge that any strange behavior Multari exhibited was because the hospital staff gave her Xanax.

Multari told the judge she had never been diagnosed with a bipolar disorder and that she never told hospital staff that she wanted to commit suicide. She said she told a nurse she was worried about how her disability, being born without half of her left arm, would affect her ability to hold her newborn.

They said there was no record of McBryar choking Multari and that it never happened. He had gotten into a disagreement with Multari’s parents, but the fight did not get physical and he left the hospital when asked. He had struggled with anger issues, he said, but had already sought treatment through anger management classes. He said he had never been diagnosed with autism, although a son he had from a previous marriage was autistic.

Later, a psychologist would find that the caseworker from Murray County Division of Family and Children Services had botched part of her initial investigation and that she had overstepped her bounds by attempting to diagnose Multari.

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"This is an incorrect statement made by an incompetent reporter who should not be making evaluations."

Dr. Leslie Ellis

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“Ms. Multari is not bipolar and should not have been labeled as such,” Dr. Leslie Ellis wrote. “This is an incorrect statement made by an incompetent reporter who should not be making evaluations.”

She also found that since the hospital’s crisis team cleared Multari, DFCS shouldn’t have been able to use the records against her. Yet the order to have their daughter removed was mainly based on the crisis team’s evaluation.

Still, it seemed too late for them to defend themselves, they said.

Once the state had the child, the couples’ lives were under a microscope.

In some ways the scrutiny seemed warranted. Their road to parenthood was rocky.

Even though they had both married young and divorced, their romance grew serious fast. They moved in together shortly after meeting in August and became inseparable.

Still, sometimes when they drank, they fought. She had a difficult time expressing herself and he talked too much. They had petty disagreements over what beer to buy or what to do on the weekend.

McBryar had a temper and sometimes, when he got angry, he would shout or punch a wall. The police were called twice in three months.

The first time was in November 2014. McBryar’s mom, Pamela, overheard her son and Multari shouting. When she tried to stop the fight and take the alcohol from McBryar, she said he turned around and hit her in the face, making her nose bleed. She called the police, even though she said he had never hit her before, and he was charged with domestic assault.

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"Please get better for us."

Diana Multari wrote to Will McBryar while he was in jail.

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The second call to police was in January. That night the couple were drunk again and belligerent. McBryar shoved Multari against a piece of furniture, and she pushed him back, scratched at his face and pulled his hair, according to a police report. Both were arrested and charged with domestic assault. But Multari’s charge was later dropped.

They thought their relationship was over. Multari moved out and went to live with her grandmother. McBryar was still in jail when Multari tested positive on a pregnancy test.

She started to write him letters.

“Please get better for us,” she would tell him.

When they found out about the baby, they knew it was time to change. They stopped drinking, and McBryar signed up for weekly anger management classes.

Multari took classes to learn how to nurse when the baby arrived. She made sure to take her prenatal vitamins. They decided they would move in with her grandmother in Chatsworth, Ga., until they could find a bigger place. The one bedroom they shared in Brainerd wouldn’t be enough space for the family. They would get married after Multari gave birth.

There was fear and worry leading up to the delivery. Multari thought the baby would come out with one arm, like she had. McBryar worried Multari would leave him like his first wife, who had taken their two sons with her.

They decided to name their daughter, Tobi, from a character in Multari’s favorite movie, where the baby is kidnapped from his family.

When Tobi was taken from the hospital in September, they couldn’t accept reality.

Multari pumped her breast milk into baggies and stored the milk in the freezer. They kept the “Baby on Board” sign in their PT Cruiser’s rear-view window and a sonogram of Tobi taped to the dashboard.

At their first court hearing six days after she was gone, Multari asked over and over: Why? What had they done?

Despite the couple’s defense, the state said Tobi was at risk. They wrote that Tobi shouldn’t return home because she “may be exposed to an unhealthy relationship between her parents.”

A social worker explained that Tobi wouldn’t have proper parental care or control at home.

They were each interviewed, then a caseworker typed up the answers in a case plan that outlined what they needed to do to get their daughter back.

The court told them they didn’t earn enough and that their one-bedroom apartment wasn’t big enough. They also said the couple couldn’t rent an apartment from McBryar’s mother.

Also, they were told to take parenting classes, couple’s therapy, complete psychological, parenting and domestic violence assessments, get hair follicle tests to check for drug use and maintain stable, clean and safe housing for six consecutive months.

And while the couple were working to get their daughter back, the state was also making plans to find adoptive parents for Tobi in case the parents didn’t meet their requirements.

McBryar refused to sign the case plan because he didn’t believe he was guilty of anything, and the social worker called him combative. Weeks later, a judge ordered him to follow the plan, or else.

The same psychologist who found fault with the state’s investigation heaped numerous new mental illness diagnoses on McBryar and Multari.

At 8 years old McBryar had been diagnosed with ADD and began to take Adderall. In high school, he often skipped classes to smoke pot and he found it difficult to pay attention. He went to three psychologists convinced something else was wrong. But each professional told him he was on the right treatment for his condition.

But the psychologist hired by the state to assess McBryar diagnosed him with five new mental illnesses after a two-hour interview and a few tests. She said he had an alcohol use disorder, an antisocial personality disorder, an intermittent explosive disorder, a borderline personality disorder and post-traumatic stress disorder.

Her evaluation also made assumptions about his past and predictions about his future.

McBryar is “unusually energetic” which most likely means he meets a diagnostic criteria for a manic or hypo-manic episode, the report stated. And because McBryar has a history of antisocial behavior, “he may have been involved in illegal occupations or engaged in criminal acts,” she wrote, citing that he had once been suspended from school as a teenager for fighting.

On the other hand, Multari was faulted for having the expectation that her children should be obedient. The psychologist suggested that she had rigid and OCD tendencies that could escalate into child abuse.

“If not modified, these traits can result in abusive interactions with children,” the report stated.

It seems strange that a person could face charges of child abuse or neglect when neither has occurred, but it happens all the time under a concept some states call “predictive neglect.” Some courts allow states to decide if a parent is unfit based on the potential threat a parent might pose with a mental illness. In Georgia, the parental rights of couples who have never abused their children can be terminated if a court determines the children are “without proper parental care and control,” meaning that a parent’s physical, mental or emotional state could lead to abuse or neglect in the future.

Still, caseworkers don’t just assume a mentally ill person will neglect or abuse their child based on a hunch. The prediction of risk must be made by a mental health professional, said Susan Boatwright, a spokesperson for DFCS.

And tests, not home visits, are standard practice in determining a parent’s likelihood of abuse, despite experts’ concern over the weight these tests are given.

“The tests likely were not developed nor really, originally, meant to be used in this way―which makes the procedure invalid,” said Joanne Nicholson, a professor at Dartmouth Psychiatric Research Center.

In fact, the American Psychological Association advises courts and professionals not to rely solely on tests and urges officials to also spend time with the family being assessed.

Still, to Murray County Judge Connie Blaylock, Multari and McBryar’s test results were enough for her to determine they weren’t ready to raise their daughter.

They said Blaylock ordered Multari to take weekly therapy for her OCD tendencies and ordered McBryar to check into a 30-day inpatient mental facility for treatment.

This, along with a $432 monthly child support payment, was added to the couple’s lengthy list of requirements.

It seemed impossible, they told each other. How could they hold a job if they were required to do inpatient treatments and continue visits with Tobi and attend court? How could they pay for child support if McBryar didn’t have work? How could they afford a larger apartment if their money was tied up in child support?

And the law said this all had to be done in four months. They asked the state for more time because the state had delayed their case, but the caseworkers blamed them for the delays.

If progress wasn’t made by June, the process of terminating their parental rights could begin.

When they realized they could lose Tobi, they began telling their story to anyone who would listen.

“Every family has issues, and while I truly believe any child being abused deserves to be protected, our family was never given a chance to succeed or fail,” Multari wrote on Facebook. “We were treated as guilty and now must prove our innocence.”

Many sympathized or said they had been railroaded. Others told similar stories of their own.

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Taken away

Barbara Blackburn (top) and Janay Millwood (bottom) talk about when the state removed their children from their homes 10 years ago. Both women were on disability and had been diagnosed with a mental illness. Neither had abused her children, but the Division of Family and Children Services said they were unfit to be mothers.

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Janay Millwood told the couple she also had lost her children because the state claimed she was mentally ill. A doctor told her she could give her 3-year-old Ritalin because of behavior issues, but a state caseworker cited her for giving the child the drug. Despite having disability income for her and her children, the state said she did not have enough money to raise them, state records show.

After one interview with a psychiatrist, Millwood was diagnosed with both an anxiety disorder and a personality disorder. In her termination papers, the state described her mental condition as: “Ms. Millwood cannot see the forest because she is quickly lost in the trees.” The papers stated that she was unlikely to accept treatment in the future.

“The court finds that the mother has a verifiable deficiency of her mental and emotional health of such duration and nature as to render her unable to provide adequately for the children,” the court later ruled.

Multari’s co-worker, Mandy Cardin, told Multari she thought the state was misjudging the couple because of their tattoos and piercings. Their assumptions were wrong, she said.

“It breaks my heart to see such an amazing person in so much pain… The state has stepped in and devastated her!! Without even having any reason,” Cardin said.

Multari reads the posts over and over.

She also set up a page for people to donate money to help them.

“The world needs to know that Georgia stole our daughter through lies and threats,” she wrote in her plea.

Every day she checked for people’s comments and donations. She read the supportive words over and over again.

At least a few people believed in her, she told herself.

Each Thursday, Multari leaves work two hours early and drives home to Brainerd from Ooltewah.

They pack the car with Tobi’s diaper bag and gifts and drive nearly 40 minutes to Dalton for their 90-minute supervised visit.

In late February, their car was only 10 feet out of the driveway when Multari realized she forgot her cellphone.

“I’ll turn around,” McBryar said as he skidded to a stop.

Her cellphone is their only real connection to Tobi during the week. Each visit, they take photos and videos of Tobi so they can remember the way she giggles when they talk and chews on her fingers.

At the visitation and mentoring center employees sit at a table, prepared to watch the couple with their baby and take notes.

“When will she be here?” Multari asks, holding a frog hat she crocheted for Tobi.

It was 3:58.

“She has two minutes to be here.”

The doorbell rings. Multari rushes out of the room. She squeals as she scoops up Tobi’s car seat with her arm.

“She’s gained weight,” Multari says, holding up her daughter.

She cradles her close with her right arm, the nub on her left side steadying Tobi’s back.

“They are such good parents,” an employee whispers. They say the same things every week.

In notes, they describe how attentive Multari and McBryar are to Tobi’s needs. When Tobi was fussy and chewing on her bottle, a January review noted that they suspected she was teething and at their next visit they brought oral gel to soothe the baby’s mouth.

When she cried, they asked the center to call her foster mom to find out how many anti-colic bottles they should buy and bring next week. When the foster mom never returned the calls, their January review noted that they brought four bottles on their next visit.

They rock Tobi, read her books, sing her songs and watch her sleep, they write.

Yet when McBryar and Multari met with DFCS they said the case manager didn’t want to see the evaluations. They weren’t “relevant,” a caseworker said.

They missed the first time Tobi laughed, the first time she lifted her head and looked around and the first time she rolled over.

And they worry what that will mean in the long run. Besides the center’s notes saying what good parents Multari and McBryar are, there are notes about how the baby is suffering from separation trauma, notes about how the baby needs to learn how to bond with her parents.

Babies start to attach as soon as they are born, and their attachment patterns can haunt them for the rest of their lives, experts say. If the baby is moved around in the first year of life, the change can cause stress that triggers developmental delays. A child with multiple caretakers could have trouble with relationships later in life, struggle to find independence, make friends or trust people, said Diane Bales, a professor of human development at the University of Georgia.

In the first week of March, Tobi was moved again, but this time to Hamilton County.

It was the first hint of good news.

After McBryar’s attorney filed a motion to appeal their case, Judge Blaylock suddenly ordered their case to be transferred to Hamilton County with little explanation.

They hope a recent change in family law could mean they get a fairer hearing.

In 2013, Tennessee amended its juvenile code to make the burden of proof higher for parents with a disability. The state has to prove that a mental illness poses a substantial threat to a child before a court can find that a parent is unfit because of their mental health diagnosis.

States now also have an added pressure from the federal government to treat parents with a disability fairly.

The U.S. departments of Justice and Health and Human Services released a joint investigation in late January that found the Massachusetts child welfare system had violated a young mother’s civil rights by assuming she was unfit to be a parent because of her intellectual disability. The state took her newborn daughter at the hospital even though the mother lived with her parents, who were also capable of caring for their granddaughter.

This is the first step for the federal government to acknowledge it is illegal to judge a parent based on a mental health diagnosis alone. In the future, parents with disabilities may start to see better treatment from their state child welfare system and get more access to the services they need to be a better parent, said Ella Callow, legal program director with the National Center for Parents with Disabilities and Their Families.

But until the federal government mandates states not to discriminate against parents as outlined in the Americans with Disabilities Act, Callow said it will still be left up to each state and juvenile court.

On Wednesday, McBryar and Multari were in court again, but this time in Chattanooga. For months, he had written motions, explaining how unfairly they had been treated, how wrongheaded the court’s requirements were, how they wanted an injunction and the return of their child. The Murray County judge ignored them all.

This time the Hamilton County judge agreed to hear him. They will return to court again next week, and depending on what happens that day, they hope Tobi could go home.

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"My biggest fear is that she is going to grow up thinking, ‘Why didn’t my parents want me?'"

Will McBryar

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The decision gave McBryar hope, and when he’s with Multari he tells her the worst is almost over. They will get Tobi back. They will keep fighting, he says when he kisses her on the forehead.

But when he is alone, he admits he feels hollow. He relives that day in the hospital over and over. He can’t move on. And he wonders if anyone will trust that they wouldn’t ever hurt their baby girl, if his family will ever be whole again.

“My biggest fear is that she is going to grow up thinking, ‘Why didn’t my parents want me?’” he said.

He did want her. They both wanted her and loved her, so much.

It’s just that, at least in the eyes of the state, that’s not enough.