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Casualties of addiction
Bill would change law to hold mothers accountable for harming unborn babies
By JULIET V. CASEY
REVIEW-JOURNAL, November 16, 2004

Law enforcement officials are pushing for tougher laws to incarcerate pregnant women who take illegal drugs that hurt their unborn babies.
But drug-addicted mothers and other officials say prison probably won't protect the unborn and won't result in treatment for the mothers.

A bill draft request being crafted by the Nevada Sheriffs' and Police Chiefs' Association would change child abuse and endangerment laws, if approved in the 2005 legislative session, to include women who know they are pregnant and whose drug use results in the death, physical or mental harm of their fetus.
"My big concern is that we have an alarming rate of pregnant women ingesting meth, and their babies are being born dead or addicted to the drug," said Mark Jackson, the Douglas County assistant district attorney who authored the proposal. "If we had a law in place to criminalize prenatal substance abuse, we could get those women off the street. We could keep them from ingesting the drugs that would harm or kill their baby."
Candice Kidd, director of the West Care campus for women and children, said 90 percent of the pregnant or parenting women at the substance abuse treatment center are addicted to methamphetamine, a stimulant that increases energy and decreases appetite.
To Michelle Mitchell, a 31-year-old mother of six who is in the West Care program, incarcerating a drug-addicted pregnant woman makes little sense.
"I've been to the pen twice because of drug-related charges," she said. "I could still get high in prison. Prison is not going to solve the problem. The babies aren't going to get well until the mothers get well."
Mitchell said her drug of choice was crack cocaine, and several of her children were born with the drug in their system. She said child protection services took five of her children, who now are with relatives in Ohio. Her youngest, 6-week-old Miracle, is staying with her at West Care.
But Tracy Fabry, a 19-year-old recovering addict, said having such a law on the books might have stopped her from injecting methamphetamine throughout her two pregnancies.
"It sounds selfish, but in my addiction, I wouldn't have cared about my children. But I would have cared about my freedom," she said.
Fabry, who is in her second month of treatment at West Care, said both her children, ages 3 and 4 months, have been affected by her drug abuse.
"My son is very hyper," she said. "And my daughter, she's slow. It takes her a while to catch onto things, like eating from a spoon. I see other babies, and I can tell it's harder for her."
The state doesn't track the number of babies born addicted or exposed to drugs, because it is difficult to determine whether women continued to use drugs into their last stage of pregnancy and because not all babies are screened, said Annie Ucceli, a spokeswoman for the state Health Division.
The U.S. Department of Health and Human Services estimates 750,000 substance-exposed babies are born each year nationwide.
Jackson said the law allows child welfare officials to take a newborn from its mother if it is born addicted or has drugs in its system. Beyond that, the state has no law that allows prosecution.
Jackson tells the story of a young meth addict who in May admitted herself into Carson-Tahoe Hospital complaining of contractions.
"The doctor delivered a fully developed baby, which was decomposed and nearly breaking apart in the doctor's hands," he said. "The autopsy showed the baby died as a result of high levels of methamphetamine toxicity. But what happened to the mother? Nothing."
Jackson said the legislation would allow different levels of punishment and opportunity for treatment, or referral to drug court where it's available. Ultimately, the proposal calls for one to 10 years imprisonment if the mother's drug use results in the death of the fetus, or one to five years if it results in physical or mental harm. If no harm results, the charge would be a gross misdemeanor.
Bob Neri, the Florida-based chief clinical officer for West Care, said Nevada wouldn't be the first state to criminalize drug abuse by pregnant women. But, he said, states that have penalties are moving away from incarceration and toward treatment.
He said that in Florida, where laws against illegal substance abuse in the 1980s and 1990s were strengthened to include harsher punishments for pregnant women, authorities found "a boom of abandoned babies and dead babies found in Dumpsters."
"Now they're using those laws as an intervention, basically telling women they could be sent to jail but they have the option of treatment," he said.
Clark County Sheriff Bill Young said he would prefer treatment as the first option, but state officials have consistently underfunded such programs.
"I believe jail time can be a deterrence, even though I know jail is not going to be the answer to this social problem," he said. "My first choice is counseling. There's just not enough, and it's something I've been frustrated with."
Court officials say they also have been frustrated, but don't believe more criminal laws are the answer.
Kandis Stake, manager of the Clark County Drug Court, said her program was designed to route drug abusers from prisons to treatment.
"We have enough people with felonies," she said. "Why would we add more or make these mothers into felons so that later they can't get a job and be a good parent?"
Frank Sullivan, a juvenile hearing master for Clark County District Court, hears about 1,000 cases of child abuse and neglect a year. About 75 percent of those cases stem from parental drug abuse, he said.
"They come in as one thing, but you soon find out the real problem, and most of the time it's meth, almost every case," Sullivan said.
He sees cases daily that involve babies who were born addicted or exposed to the drug.
Still, Sullivan said he doesn't think the proposed law would have much of an impact, because the prison system has done little to help drug addicts overcome their problem.
Susan Klein-Rothschild, director of Clark County Family Services Department, said she agrees with the intent of the proposed legislation but wonders if it will achieve the desired effect. She worries more pregnant addicts will "go underground" and avoid treatment or prenatal care for fear of going to prison.
But Jackson counters with national statistics that indicate 44 percent of women who use illegal drugs already are underground and don't seek prenatal care.
Klein-Rothschild said if the intent of the proposal is to protect children from the lifelong effects of their mothers' substance abuse, it should include alcohol.
"It shouldn't focus on one substance that harms the baby but ignore another," she said.
Dr. Colleen Morris, a geneticist and researcher on mental retardation who teaches at the University of Nevada School of Medicine, said the effects of alcohol on a fetus are worse than those of any illegal drug.
"Alcohol is actually the worst in terms of the effects it has on the central nervous system and abnormalities it can cause to brain development throughout the entire pregnancy," she said.
Morris said alcohol also can cause babies to be born with small brains and other birth defects, such as cleft lips, club feet and underdeveloped organs.
She said the use of meth appears to result in fewer birth defects but can affect the baby's ability to learn.
"There is a high number of individuals using meth in pregnancy, but many people who use meth actually use alcohol to modulate the effects of the drug, and obviously the combination is more dangerous to the fetus," she said.
Jackson agrees alcohol is a problem, but said including it in the legislation would be difficult because alcohol is a legal substance.

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