Whatever has gone wrong in Massachusetts has gone far worse in other parts of the United States. Nineteen states (including Massachusetts) are being sued for their systems’ failure to protect children; Mississippi’s Division of Family and Children’s Services is struggling to avoid being put into receivership. Last year, the Annie E. Casey Foundation ranked Massachusetts third best in the nation in the over-all well-being of children. The best is not good.

In January, 2015, when Charlie Baker was inaugurated the new governor of Massachusetts, he named Spears as the new D.C.F. commissioner. She took office in February. Not long after that, a seven-year-old boy who was in the custody of his father, but whose case had been overseen by the D.C.F. for more than five months, was brought to the hospital with burns on his feet and bruises all over his body and weighing only thirty-eight pounds; he has been in a coma ever since. How had caseworkers not noticed that the boy was being beaten and starved? The D.C.F.’s investigation into the case concluded that the department has been “unable to successfully implement and sustain meaningful change over time.” Spears had been in office for barely four months when, in June, Baby Doe washed up on Deer Island in a plastic garbage bag as dark and as fathomless as the very bottom of the sea.

The overwhelming majority of children who die from abuse or neglect are under the age of four; roughly half are less than a year old. In September, 2015, the New England Center for Investigative Reporting, a “Spotlight”-style nonprofit, released a story called “Out of the Shadows: Shining Light on State Failures to Learn from Rising Child Abuse and Neglect Deaths,” reporting that a hundred and ten Massachusetts children died between 2009 and 2013 in circumstances suggesting abuse or neglect, and that a third of them had been under the care of the D.C.F. (This rate is the national average: across the country, about one in three children who die from maltreatment belongs to a family that had previously drawn the attention of child-protection services.) Long before anyone knew her name, it seemed all too likely that this would turn out to be the case with Baby Doe.

Even the best reporting, though, can’t help missing a feature of the story that can be seen only from the vantage of history. Child protection is trapped in a cycle of scandal and reform. The D.C.F. was established in 1980, as the Department of Social Services, in response to the Gallison case. It was renamed the Department of Children and Families in 2008, under the Act Protecting Children in the Care of the Commonwealth, an omnibus reform that also created the Office of the Child Advocate, in response to the case of an eleven-year-old girl who was brought to an emergency room in a coma, having been severely beaten; one doctor said that her injuries were so grave it was as if she’d been in a high-speed car accident. Social workers had earlier investigated charges of abuse but had determined that the injuries were self-inflicted. The law came with virtually no new funding. (About the only mention of money, in the legislation itself, is this: “The department may pay a sum not to exceed $1,100 for the funeral and burial of a child in its care.”) It was passed in the midst of both a global financial collapse and an opiate epidemic. From the time that the D.C.F. got its name until 2014, its budget was cut every year; adjusted for inflation, more than a hundred and thirty million dollars was slashed. (In the wake of Jeremiah Oliver’s death, money has begun to trickle back.)

Programs for the poor are poor programs. And they are made poorer when they fail, and when they are needed most. Natural disasters like blizzards, earthquakes, and hurricanes drive reform and the allocation of resources, leading to improvements in public safety. The tragic but ordinary deaths of people in situations in which people are likely to die don’t usually change policy. When someone dies in an ambulance, that death is not generally followed by an investigation into the qualifications of E.M.T.s. “We don’t stop funding FEMA when the economy gets bad,” Maria Mossaides pointed out, when we met. Mossaides, an attorney, was hired by Michael Dukakis in 1977 and moved into child welfare soon after the Gallison disaster. Deval Patrick had hoped that Mossaides would be willing to serve as D.C.F. commissioner. Instead, she accepted Baker’s offer to become the state’s new director of the Office of the Child Advocate. One feature of a scandal-reform cycle—“Kids die and heads roll,” she says—is a policy pendulum. “The pendulum has swung at least four or five times in the last forty years,” Mossaides says. It swings between family preservation (keeping kids with their family of origin) and removal (removing kids from their homes and severing parental rights so that the kids can be adopted). “We inevitably have cases where we don’t get the safety assessment right,” Mossaides says. “Then you have the high-profile death, and the pendulum will swing in the opposite direction.” When Jeremiah Oliver was reported missing, the governor’s office was boasting that the number of children in the care of the state was down to seven thousand: family preservation was the priority. Two years later, that number has risen to ninety-two hundred, a record. “Pull every kid” is what Mossaides suspects D.C.F. workers are being told. “The only way that happens is social workers have become afraid to leave kids with their parents.”

This didn’t start in 2008 or even in 1980. The child-protection movement has origins in 1837, with “Oliver Twist,” Charles Dickens’s indictment of England’s Poor Laws. The policy pendulum was already so firmly in place by the eighteen-eighties that it was accurately described in a treatise called “Children of the State,” by Florence Davenport-Hill, an early advocate for foster care: “First we find the children placed in homes, but not safeguarded,” then “abuses are discovered” and the children are “in consequence massed together in some big institution” until there, too, still more abuses are discovered, and “in desperation they are dispersed again,” until, once again, abuses are discovered in homes, and the children are sent to institutions. The oscillation lately isn’t between foster homes and institutions but between reunification and termination of parental rights. The pattern remains the same.

Other patterns remain in place, too. Victorian child-savers enlisted public support by telling sensational stories involving the deaths of poor children, especially babies. It became a convention of the dead-baby story to suggest that poor women are not to be trusted with babies, and as a result the public favors rescuing children but not if it means helping women. As a rule, setting the interests of poor children against those of poor women leads to reforms that fail, which leads, a few years later, to another dead-baby story. This next time around, the reform itself is blamed for the death of the baby, and an opposite reform is proposed. It, too, fails. And then the cycle begins again.

“Baby farming,” a term coined in a British medical journal in 1867, was what Victorian doctors called it when desperately poor women paid even poorer women to take care of their babies, or, rather, doctors said, to deliberately kill them; many of the babies died of maltreatment, others of outright starvation. In 1871, the Infant Life Protection Society proposed legislation requiring childcare providers to be licensed by the state. The National Society for Women’s Suffrage formed a Committee for Amending the Law in Points Wherein It Is Injurious to Women, arguing not only that it would “legislate on matters affecting women without their consent” but also that it began “at the wrong end”: it failed to address or even to see the real problem—the political and economic inequality of women. In New York in 1874, the Times reported that a girl named Mary Ellen Wilson was “rescued” from her home by a charity worker whose husband happened to be a newspaper reporter. The rescue was made possible with the help of the Society for the Prevention of Cruelty to Animals. This and other cases led to the founding of the Society for the Prevention of Cruelty to Children. It did for children what its sister organization did for animals. “Lists of ‘saved children’ joined those kept for ‘redeemed dogs,’ ” Judith Sealander reports in her jaundiced history, “The Failed Century of the Child.” Sealander argues that the dead-baby story proved so successful because infant and childhood mortality was falling, fast. “Before the early nineteenth century, the average child was the dead child,” Sealander writes. “For most of human history, probably seven out of ten children did not live past the age of three.” If Victorian- and Progressive-era middle-class moralists were newly concerned about the dead and dying babies of the poor, it was partly because their own babies were, for the first time, not dying. And the more the children of the better-off were cherished, and pampered, the worse the treatment of the children of the poor appeared to be. In 1920, the Massachusetts Society for the Prevention of Cruelty to Children issued a pamphlet, aimed at well-to-do children, inviting them to join the society’s Junior Division but taking pains to protect them, even, from the pain of reading the stories of less fortunate children: “We cannot tell you much about our cases because they are too sad.”