Well, I haven't read all this so I might be missing some, but I read a bunch. It sounded like part of the reason you don't want to separate is probably because your wife is actually doing a lot of the child care, even if she's not doing it well, and you really need someone to do that. Working two jobs, there's no way you can be attending to kids all the time. You said you were struggling to earn enough before you get sick again, so chances are you don't feel like you could handle paying a lot for child care, which is always a big expense, or cutting back your hours to do more child care yourself. Maybe you're not even comfortable doing some of the more intimate child care that men usually leave to women, I don't know. Maybe you've done some of it since your wife is so incompetent. I guess they'd be better off if you did the best you could with them on your own and use paid child care instead of leaving them with her while you're at work. (You'd have to figure out how to prove you should get custody, but other people already made suggestions about that.) I know doing the child care yourself means you can't work as much and probably have to lower your standard of living. My vote is that's still better for the kids... and you... once you make a break for it.