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Drug-Addicted Women Need Medical Care, Not Jail

April 24, 2008

I want to spend some more time looking at research/writings on this topic in general, but at first blush I’m more than a little appalled by this story, in which a 7-month-pregnant Tennessee woman was taken to jail after seeking medical care for chest pains because she had cocaine in her system.

I think we can all agree that it’s better if pregnant women don’t use drugs that could potentially harm the fetus (although you might want to do a little reading about the myth of the crack baby and the racist/classist undertones that fueled that particular bit of hysteria), and we know that illegal drug use is, well, illegal, even if the particular laws are unjust or insensible. Let’s just start from those two bits of assumed shared knowledge, to avoid the “But it’s illegal!” comments that don’t really address the heart of the situation. We’ll get to that later.

To assume that hauling a pregnant woman to jail for drug use is the best option, you need to assume that:
-Treatment for drug addiction isn’t a better solution (both immediately and in the long term) than jail, either for the individual or for society.
-Jail provides some kind of incentive to cease drug use, and/or drugs are not available in prison.
-Jail/prison provides adequate healthcare that does not endanger the woman or fetus beyond what is experienced in her community.
-Policing pregnant women who are attempting to seek medical care won’t discourage future women from seeking care and further endangering women and fetuses.

That’s an awful lot of assumptions.

Obviously, there are some folks arguing that jail was appropriate because the rights of the fetus at some point trump the rights of the woman. Tennessee Right to Life’ president said, “If she used cocaine, she put her baby in jeopardy. It is child abuse. It certainly is.” I’d like to know where this would stop – if you ride in a car, go to work, go home to an abusive spouse, leave an abusive spouse, smoke a legal cigarette, drink a legal beer, live in a polluted neighborhood, and so on, you may “put your baby in jeopardy.” All of those items may result in the exposure of the fetus to potentially harmful actions or substances. If the “protect the baby at all costs” argument is to prevail and suggest that pregnant women willingly being exposed or exposing oneself to potentially harmful acts or substances constitutes “child abuse,” logically it must prevail not only for illegal potentially harmful exposures. The emphasis here is on “potentially,” because not every exposure of any of these substances/actions will result in adverse outcomes in the fetus.

However, if we put aside the question of the woman’s rights and decide we want to protect the fetus/child at all costs, is jail the right place for the pregnant woman, who carries the fetus? Medical care in jail/prison is notoriously bad, and completely inadequate for pregnant women, who may have complications and need immediately available specialized care. Likewise, this woman “faces one to two years of probation or jail” – does it make sense that it’s better to throw this woman away by sending her to jail, putting her kid in the system, rather than simply providing her the adequate medical care she needs to address her drug use issues? Is that best for the child?

The article on this story provides a pretty good snippet about concerns about discouraging care:

In addition to deterring women from seeking treatment, Mark J. Bliton, a Vanderbilt University associate professor of medical ethics, said arresting pregnant women doesn’t solve the problem. He said studies have shown that drug treatment is more effective than jail in preventing future drug use.

This is a misguided way to help the most vulnerable pregnant women and fetuses,” Bliton said. “The right way to handle this is to provide prenatal support and treatment.”

Bliton said he has grave concerns that Jones’ privacy rights may have been violated.

“In general, health-care information shouldn’t be shared with people who are not involved in providing health care,” he said.

Finally, back to the argument about “but cocaine is illegal!” The arresting deputy has stated that she never would have arrested the woman if she hadn’t been pregnant. The deputy attorney general has said that the woman might be charged with “reckless endangerment with a deadly weapon,” the weapon being cocaine. We are so not talking about the do drugs=go to jail issue here, it’s not even funny.

I am by no means the first person to talk about what a misguided approach this is. Please see the website of the National Advocates for Pregnant Women, especially their statement on pregnancy and drug use.

Recent related post: Pregnant Drug Users in Alabama Getting Jail Time Instead of Help

[Hat tip to Katie Allison Granju at Knoxville Talks]

14 Comments leave one →
  1. April 24, 2008 11:38 am

    Do you ever read stuff like this and wonder about how soon it will be before menstruating women are each assigned our own police officer to make sure we do nothing wrong?

  2. April 24, 2008 12:02 pm

    B, yes, and I’m not really inclined to take an “Ofwhatever” name.

  3. onesillyme permalink
    April 24, 2008 8:36 pm

    The hospital policy was to contact CPS if an unborn child is considered at risk. I’ve been taught as a mandated reporter that when in doubt make the call and let CPS determine if the case is one they can work, so I can understand their reasoning. The hospital, however, might want to re-consider their policy given that CPS there says they can’t act until a child is born. Perhaps the hospital Social Worker could be called in to offer referral for treatment or other appropriate services? Or maybe CPS could refer her as a “courtesy?” However, the guard and hospital are in all kinds of dual roles that create ethical conflicts. Not to mention, have they heard of HIPPA?

  4. B;ie Simner Daze permalink
    April 24, 2008 9:48 pm

    This is a real toughie. In theory, you are absolutely right. In practice, it’s a little more complex. I used to work in child welfare, where it was not all that uncommon to see a woman who had given birth to three, four or more drug-exposed kids. Now from the kids’ perspective, they were, as a judge friend of mine once said, denied due process before they were even born. And the damage in most cases is not repairable. So while I support treatment about 1000%, in most cases I think “just do whatever it takes to keep her clean until the baby is born.”

    • Linda permalink
      January 21, 2011 11:39 pm

      As the Mother to a drug addicted pregnant daughter I say do whatever it takes to keep my daughter clean and raise the probability that she will have a healthy baby. Court ordered confinement, a residential facility, even threat of prosecution. She’s an addict, that is ruling her life. No baby deserves the pain of being born addicted and with serious health and mental issues for their entire life. If she is chosing to carry a baby full term, she need to understand that Family Services will be there at birth to take the baby and arrest her. Then we have another special needs child that too few are brave enough to raise. Screw civil rights and the moral legalities of it. What’s right is right.

  5. April 25, 2008 6:34 am

    Onesillyme – Thanks for sharing your thoughts on this – getting the woman referred to appropriate services is, in my opinion, exactly what is needed.
    Daze, “just do whatever it takes” – Again, that assumes that hauling someone to jail necessarily keeps them clean, and that you’re actually protecting the fetus, which may not be the case given the points raised above. If a woman is having multiple drug exposed children, there is obviously something going on (say, drug addiction needing treatment…) that needs to be addressed appropriately (drug treatment) rather with just stern provider lectures and then jail. We wouldn’t expect people to recover from diabetes if they went to jail, I don’t see why we would expect it for drug addiction.

  6. blue sumner daze permalink
    April 26, 2008 10:49 am

    Rachel, I agree. Prisons are notoriously awful places to house anyone, let alone a pregnant woman with drug addiction in need of treatment and a likely fragile and already undernourished unborn child who may have or be on the way to brain damage,and becoming the world champion incarcerator does not speak well for us as a nation.

    The most successful program I’ve seen is Haymarket House in Chicago, which keeps women and their kids together and tries to teach parenting skills while Mom is learning to keep drug-free. They have worked wonders in some cases, but even they have failures. And from the viewpoint of a judge who may have seen the same parent before him/her over and over, I can understand his/her frustration. No, prison is highly unlikely to ever rehabilitate Mom. But something that at least keeps the child from being more damaged begins to look like a better alternative. And waiting for the child to be born and then swooping down and snatching the baby up can be too late. And without the full history of this case, while it sounds outrageous at first blush,and it certainly is not the preferred course of action, I’m not going to attack the judge – Just like I wouldn’t want my doc to diagnose me based on one symptom without taking my medical history.

  7. April 26, 2008 1:58 pm

    Blue, your comment raises a good point I think, which is that there’s not one single person in this case (or similar cases) who should be “attacked” – I think it’s an entire mindset/approach/system failure.

  8. April 26, 2008 7:45 pm

    Thank you so much for this post! I am looking forward to working with women in the prison system who are pregnant. The residency programs I am interested in does deliveries of prisoners.

    I think it is utterly unfair to treat a women more punitively if she is pregnant. I think if anything, it should be the other way around. Obviously she is addicted or has an issue with the drug. She went to the hospital and that should be commended, and her illness should be treated. What a way to make people not honest with their caregivers – arrest them.

    I love this website:


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