The Real Cost of Prisons Weblog

Much has been written about the rush to judgment that occurred in the 1980s around the problem of cocaine use and so-called “crack moms” and “crack babies.” At that time, it was believed that children exposed prenatally to cocaine would be inevitably and irrevocably damaged and that their mothers were unfit to parent. Public outrage led to the arrest of women who were pregnant and could not overcome their addictions. Courts in every state except South Carolina have said such prosecutions violate law and common sense.

All this, and almost 20 years of research has yet to identify a “crack baby” syndrome. From a scientific point of view, the outrage was unwarranted and policies misguided. The idea that cocaine caused serious damage to the fetus was based more on animal studies than human studies. And in those human studies, methodological flaws were well-documented. Yet the public and child welfare officials alike assumed that pregnant women who used cocaine could not be trusted to bring up their children.

We have learned a lot since the 1980s. We know that drug addiction is a disease, a complex disorder involving the brain. And we know more about the effects of prenatal cocaine exposure. The largest study, of more than 8,000 deliveries, showed that medical problems in cocaine-using pregnant women occur less than 5 percent of the time and were not related to cocaine when variables such as alcohol and tobacco use were controlled.

Because the court said Ms. McKnight did not receive a fair trial, the state was entitled to re-try her — to have a second chance to prove that her cocaine use caused the stillbirth. Even though, as a matter of science, the state would be unable to do this, continuing to fight would mean enduring another murder trial and risking another conviction in spite of the truth. By pleading guilty to involuntary manslaughter, Ms. McKnight could finally get out of jail and avoid additional years of uncertainty and anguish. No woman, however, should have to plead guilty to a crime she didn’t commit.

At least 96 other women in South Carolina have been arrested, some for homicide, most on lesser charges of child abuse and drug delivery, because they continued their pregnancies in spite of a drug or alcohol problem. At least 12 criminal cases are pending. Many, many more cases are in the civil child welfare system because South Carolina treats a single unconfirmed positive drug test on a pregnant woman or newborn as a basis for presuming neglect. As a result, too many children have been removed from their homes and separated from mothers and families who love them. All this because policy and law lag behind medical understanding.

Yes, there are things women do that increase health risks during pregnancy, but they generally have more to do with poverty and lack of access to health care than anything else. And yes, there are drug users who are inadequate mothers, but there are also drug users who are competent mothers. With the support and treatment, they can care for their children. Families can be preserved.

It is time for South Carolina and its Supreme Court to reexamine its costly and counterproductive approach to the issue of pregnant women and drug use. Neither continuing a pregnancy to term nor suffering a stillbirth should be treated as a crime. The real crime is for the state to continue to ignore science and the overwhelming evidence that treatment, not punishment, is what is best for pregnant women, children and families.

Ms. McKnight was released from prison last month.
Dr. Lester is a professor of psychiatry and pediatrics at Brown University; Ms. Veer is chief executive officer of Carolina Health Centers in Greenwood.
http://www.thestate.com/editorial-columns/v-print/story/448487.html
The story of Regina McKnight is featured in the RCPP comic book, "Prisoners of a Hard Life: Women and Their Children" which is posted on the Real Cost of Prisons website: www.realcostofprisons.org and then to Comic Books.