Keeping Mothers and Their Infants Together: Barriers and Solutions


Our society has been shocked by the growth of cocaine use among pregnant women in the past decade. While the overall use of cocaine, including crack, has dropped in the 1990s, its use by women of childbearing age has grown? A study in one Florida county found that approximately thirteen percent of women tested positive for alcohol or drugs during pregnancy. In 1990, women addicted to cocaine gave birth to an estimated300,000 infants.

The government and the medical, legal, and social service communities have been hampered by lack of experience with and lack of reliable data regarding the pregnant cocaine user. Thus, these communities have responded toward pregnant women’s cocaine abuse with a number of strategies which have varied in their effectiveness. With a significant outpouring of federal funds, some state and federal authorities have laid a foundation for a realistic treatment approach. These combined state and federal efforts have helped some women and children. Society has also responded, however, by viewing a pregnant woman’s cocaine abuse as a crime against the unborn rather than as an illness in need of treatment. Under this view, social service and legal agencies, often with the aid of the medical community, seek to punish the drug-using pregnant woman with incarceration and the removal of her newborn and other children.

Such retributivist reactions are unlikely to benefit either the child or society. Current scientific evidence does not conclusively demonstrate that maternal drug use directly or substantially causes the poor development found in children of drug-using mothers. Additionally, research into the long term behavioral and developmental effects of prenatal drug exposure is scant. There is likewise no evidence that shows that a drug addict is necessarily a bad parent. In fact, the reality that the foster care system is ill-equipped to care for the special needs of a drug-exposed child may mean that the removal of such a child from her mother could harm her long-term recovery.

Furthermore, separation of a child from her drug-addicted mother results in added costs to an already over-burdened judicial and foster care system. This unnecessary expense diverts funds from treatment and prevention programs. Finally, criminalization or stigmatization of prenatal drug use deters pregnant women from seeking drug treatment and prenatal care. Regarding pregnant women’s drug use as a crime, therefore, is both ineffective and counterproductive to the goals of mother, child, and society.

Instead, the governmental, medical, social, and legal entities involved in drug treatment and child protection should treat pregnant women’s drug abuse as an illness. Efforts should focus on developing treatment and prevention programs carefully tailored to the individual case of mother and child. These programs must view the pregnant drug user nonjudgmentally and provide the comprehensive services she needs. Along with drug treatment and pre- and postnatal care, such services may include vocational training, parenting training, mental health evaluation, and social support after treatment. Given the inefficacy of punishing drug use during pregnancy, the overwhelmed state of the courts and foster care system, and the lack of scientific evidence regarding the precise effects of prenatal cocaine exposure, such comprehensive treatment, prevention, and support programs for pregnant substance abusers benefit mothers, children, and society.

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