Recently, National Advocates for Pregnant Women [8], the Drug Policy Alliance [9] and the Southern Poverty Law Center [10] filed an amicus brief [11] on behalf of leading public health professional and advocacy organizations in support of an Alabama mother who was convicted of “chemically endangering” her “unborn” child. The state claimed that the newborn she had carried for twenty-five weeks and undergone cesarean surgery to deliver, died because she used a controlled substance while pregnant.
Reactions to another blog [12] about the same case reveal that some people believe such convictions are justified because a pregnant woman who uses an illegal drug will cause her child “all sorts of brain damage, stunt its development and even kill it.” While such beliefs are widely held, experts tell us that they are far from accurate.
We should pause here to say that if what you want to do is judge pregnant women, then you probably should stop reading now. But, if you actually care about babies you might want to find out what the experts have to say.
What you will find out is that scientific and medical research does not always conform to our beliefs. Sometimes it does not even match what the media told us were “expert” views.
This is especially true when it comes to pregnant drug using women. For nearly two decades popular media claimed that any illegal drugs used by pregnant women would inevitably and significantly damage their babies.
The actual scientific research contradicts this assumption. Carefully constructed, unbiased scientific research has not found that prenatal exposure to any of the illegal drugs causes unique or even inevitable harm. This research is so clear that that courts and leading federal agencies have concluded that what most people heard was “essentially a myth.” As the National Institute for Drug Abuse explains, “babies born to mothers who used crack cocaine while pregnant, were at one time written off by many as a lost generation. . . . It was later found that this was a gross exaggeration.”
Leading researchers, publishing in the most highly regarded, peer reviewed journals, warned about a rush to judgment. And when research results started to come in, they found that the harmful effects of illegal drugs, when they could identify any, are less severe than those of alcohol and are comparable to those of tobacco: two legal substances used much more often by pregnant women, despite health warnings. By the way, here is what a citation to a responsible medical research article looks like: Deborah A. Frank [13] et al., Growth, Development, and Behavior in Early Childhood Following Prenatal Cocaine Exposure: A Systematic Review, 285 JAMA 1613 (2001) [14].
Yes, marijuana, cocaine, and methamphetamine are illegal, but not because our legislators determined that these drugs pose unique risks to fetuses. (To find out why some drugs are regulated by the FDA and others by the police, read Drug Crazy [15]).
Fortunately, some people are beginning to listen. For example judges on South Carolina’s Supreme Court listened. As a result, they unanimously overturned the conviction of a woman who’s drug use allegedly caused a stillbirth. The judges agreed that the research the prosecutor relied on was “outdated” and that counsel failed to call experts who would have testified about “recent studies showing that cocaine is no more harmful to a fetus than nicotine use, poor nutrition, lack of prenatal care, or other conditions commonly associated with the urban poor.”
Even the popular press is catching up. For example, the Kansas City Star [16] reported that “[a]fter monitoring these children into their teen years, researchers think cocaine exposure is less severe than alcohol and comparable to tobacco use during pregnancy. The Oklahoman [17], reported that “[d]eepening research shows babies who are exposed to cocaine or methamphetamine in the womb fare similarly to other babies as they age.” And the New York Times ran a story last year entitled: The Epidemic That Wasn’t [18].
Even if prosecutors don’t get it, many state legislators do—which is one reason why state legislatures in Alabama and across the country have refused to pass criminal laws specifically directed to pregnant drug using women.
They understand that ignoring current scientific research about drug use and pregnancy can also be dangerous to children. The assumption that every child prenatally exposed to a drug is damaged has led to kids being labeled and teased [19] and to schools assuming such kids cannot learn [20] when in fact they may be high achievers [21]. Such assumptions have even been used to distract from real instances of child abuse. For example, when New Jersey community members noticed that four adopted boys in a large family looked undernourished, the parents said “the four brothers had been born addicted to crack cocaine and had an eating disorder.” [22] That was enough to stop the inquiries until the boys were near death because their adoptive parents were starving them.
So before you comment about pregnant women and drugs please look at the research. And if you see a comment about this subject that sounds like it is based on an assumption, demand, for the sake of pregnant women and their babies, that the author provide support for the claim by posting this simple statement: “source and citation needed.”