ARRESTING MOMS ON COKE IS NOT THE BEST SOLUTION The U.S. Supreme Court will wrestle with the issue of whether the Constitution permits a public hospital to report pregnant women who test positive for cocaine to the police. Meanwhile, citizens ought to examine another question: Is this an effective way to protect children? At issue is a policy at the Medical University of South Carolina in Charleston under which pregnant women were tested for drugs without a search warrant. Evidence for those who tested positive then was forwarded to police who took the women into custody. Proponents of the policy argue that expectant mothers who use cocaine are guilty of giving drugs to an unborn child or to have committed child abuse. Opponents argue that this constitutes a warrantless search and that sanctioning such policies would give police unlimited authority to act on supposedly benevolent motives. Few would argue that it is OK to jeopardize the health of a fetus by using narcotics. And, indeed, using cocaine is illegal. But we, as a society, need to consider the ramifications of turning the results of drug tests over to police without the explicit permission of the patient. And a Supreme Court decision upholding the Charleston policy would be a green light to initiate similar policies in other areas. Beyond the legal issues, however, there is good reason to question whether such a policy achieves its stated purpose or, in fact, whether it might not impede efforts to protect unborn children. "If the real interest here is producing healthy babies and healthy pregnancies, then criminal prosecution is not what works," said Priscilla Smith, an attorney for the Center for Reproductive Law and Policy who represents the women suing the city of Charleston. Opponents of the policy argue that it both intrudes on the doctor-patient relationship and deters pregnant women from seeking prenatal care. The Charleston policy was modified to offer drug treatment as an alternative to arrest, but that still could be a deterrent. And why focus only on mothers who abuse cocaine? Research has shown that use of tobacco and alcohol can result in more serious birth defects than cocaine use, and smoking and drinking during pregnancy certainly are more widespread than sniffing cocaine or smoking crack. Opponents of MUSC's policy charge that racial bias also is involved. The hospital's patient population is overwhelmingly poor and black. All but one of the women arrested under the policy were African-American. Who might be swept up in the dragnet if the state suddenly decided to crack down on pregnant women who drank half a bottle of wine or smoked a pack of cigarettes every day? The point is, as attorney Smith stated, there are better ways to produce healthy babies. Instead of threatening to put women in jail, the state could undertake an effort to educate poor women without access to health information about how best to take care of themselves and protect their unborn children. Researchers reported this week that birth defects in South Carolina have dropped by half since a statewide campaign to increase women's folic acid intake. Still, only about a third of pregnant women are getting the necessary 400 micrograms of folic acid each day. Ensuring that all pregnant women know they should take this inexpensive and widely available vitamin is a far better and more cost-efficient way to protect babies than depriving expectant mothers of their constitutional rights and threatening to throw them in jail.
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