Drug use during pregnancy: Conclusions

If you have not already done so, it’s a good idea to read the introduction to this discussion first.

Father, mother, daughter, and daughter-to-beI was saddened to see that so many students in our class were in favor of adding punishments to mothers who use drugs during pregnancy. I realize that their hearts are in the right place—nobody wants to see mothers poisoning their babies with drugs, including alcohol, and increasing the odds of serious problems in the child. I just don’t think that most of my classmates have any real understanding of how addictive drugs are.

Gayle Newton related a story about how her sister, addicted to heroin, killed two of her own children and eventually died herself from the addiction, because she could not stop using the drug.[1] Kellie Burns’ sister was so far into drugs that she willingly dropped her kids off on a doorstep, and there wasn’t “a law or police officer that could have stopped her” because she was so high on meth.[2]

In order for punishment to work as a deterrent, people have to have a rational fear of the consequence, and thus want to avoid it. Addicts often behave irrationally, and the highs can make them feel invincible. “You think you can tell me what to do? Just try and stop me!” Later, when the high wears off and the depression sets it, users can feel so remorseful that the only “rational” thing they can think to do is to get high again so they stop dwelling on how overwhelming everything is in their lives.

I do not think anyone came up with a viable solution to the problem. Some people recommended rehabilitation.[3][4][5][6][7][8][9][10] Kellie’s sister’s experience in “an intense rehab women’s boot camp” mandated by a judge was not much help.[2] “[S]he came out even more of an addict than when she went in.” In researching this topic, I found that many rehabilitation programs are based off of successful programs for rehabilitating men. The reasons that women become addicted to drugs is often more complex and more emotion driven, and expecting women to respond the same way that men do in a rehab program is an unrealistic expectation. A “boot camp”, whether marketed to the courts as being “for women” or not, does not sound like the type of place where positive results are likely. Little wonder that the sister came out in worse shape than she was in before.

Other classmates felt that time in prison was the answer. There seemed to be no consensus (or usually even discussion) about when that prison sentence should be carried out. If the sentence was to be served during pregnancy, it would presumably be to force the woman into a presumed drug-free environment. Ignoring reports indicating that drug use within our prison system is a serious issue, few people seemed to realize or care that prisons usually do not offer drug rehabilitation programs; the women (and fetuses) would go into detox cold turkey—not something particularly healthy for the mother or the fetus. There is also the matter that prisons generally do not provide prenatal care. A functional addict is at least likely to continue seeking prenatal medical care for the child, but in prison, that would be denied.

Several students indicated that surgical sterilization, or “tying her tubes”, would be an acceptable punishment in their eyes for such a mother. I am in shock over that suggestion. Is there a more basic human right than to procreate? In an anthropology class I took a couple of years ago, one definition of an unsuccessful person was someone who never had offspring that had children of their own. In other words, if you are unable to pass along your genes into a second generation, you are a failure. I still do not know if I fully agree with that definition, but it does illustrate how important a right it is for a person to be able to bear children. Fortunately, our courts currently agree that permanent sterilization is not an acceptable punishment.

A more modest proposal was to implant removable IUDs within women who were incapable of or unwilling to act responsibly when it comes to sex and drugs.[1][6][8] This option at least allows a woman the option of having children later, after she has been sober for a period. Other than the fact that I thoroughly detest the thought of a government mandating that any medical procedure be used on its citizens as a punishment, I do not see much else wrong with this proposal. Perhaps, if it were voluntary, this could be a helpful step in the right direction, though it should really be one part of a comprehensive plan to help the woman.

I think we all realized that the biggest problem with any type of program to prosecute mothers who use drugs during pregnancy was the enormous bureaucratic nightmare that such a plan would create. Who would be responsible for monitoring and reporting the drug use? If medical professionals do it, then many healthy women would be scared to obtain prenatal care on the off chance that something might be found. If imprisoned, where would the women be held? Our prison system is already overcrowded, and that would be a terrible environment for a pregnant mother. Likewise, our foster care system is a mess, and requiring that children be removed from their parents in such systems would only make the situation worse. There is also the cost of any of these solutions. When schools do not have money to pay teachers and cities are on the verge of bankruptcy, where would funding come from to pay for such an expensive bureaucracy or for unconstitutional medical procedures? Even funding for proper rehabilitation and ongoing support would be prohibitively expensive.

This is an issue with no easy answers and still a lot of room for discussion and debate.

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