WOMEN GIVING BIRTH IN HANDCUFFS

MAYBE the recent U.S. Supreme Court decision that hospitals cannot screen
pregnant women for drug use without their consent will put aside our desire
to punish "bad mothers" and instead focus on policies that actually improve
fetal health and salvage people caught in the throes of addiction.

The court's surprisingly strong 6-to-3 Ferguson v. Charleston ruling
illustrates that even a conservative court has limits beyond which it will
not tread.

The decision sends a message that fundamental rights to privacy and freedom
from involuntary search and seizure cannot be infringed upon simply because
a woman is pregnant.

Perhaps the justices were appalled by the police-state tactics in the case;
if not, they should be. In 1989, the Medical University of South Carolina,
the only public hospital within a 50-mile radius that accepted Medicaid
patients, began selectively screening pregnant women for illegal drug use.
Even though the tests detected all drugs used, only positive cocaine test
results were reported to police and prosecutors. Prenatal patients, testing
positive, were told they must successfully enter into drug treatment or
face prosecution. Initially, women who first visited the hospital, while in
labor, were simply arrested after giving birth.

Later, these women were given the option of deferred prosecution,
contingent upon their completing drug treatment. Over the next five years,
nearly 280 women, the vast majority of them African-American, were arrested
or threatened with prosecution. Some women, only hours after giving birth
and in handcuffs and shackles, were taken to jail. Others were kept in jail
until they went into labor and then taken in chains to the hospital by
ambulance.

At least one woman, Lori Griffin, was handcuffed and shackled throughout
her entire delivery.

The ostensible rationale for the program was to scare pregnant addicts into
getting drug treatment so that they had a better chance of giving birth to
healthy babies.

This laudable goal was undercut by the severe lack of drug-treatment slots
for pregnant women in Charleston.

For the first two years of the screening, the Medical University of South
Carolina's own in-patient drug treatment program refused to accept pregnant
women.

In fact, no residential treatment program in the Charleston vicinity
accepted substance-abusing women and not a single out-patient program
provided child care or transportation so that women with children could
participate.

Aside from civil libertarians, the group most likely to applaud the Supreme
Court's decision are those who work with pregnant addicts, medical-care
providers, including drug-treatment professionals. All of their
professional associations -- the American College of Obstetricians and
Gynecologists, the American Medical Association, the American Nurses
Association, the American Society of Addiction Medicine, the American
Academy of Pediatrics and the American Public Health Association -- are on
record as opposing criminal prosecution of pregnant addicts.

It turns out that criminal prosecution actually deters women from seeking
prenatal care and drug treatment, both of which substantially improve birth
outcomes.

Moreover, nearly all U.S. correctional facilities do not meet the minimum
levels of obstetrical and gynecological care established by the American
College of Obstetricians and Gynecologists.

Although there is no silver bullet that will end drug use by pregnant
women, the evidence overwhelmingly indicates that drug-treatment programs
designed to address the specific needs and causes of addiction among women
do work. Studies also show that pregnancy itself often motivates addicts to
seek treatment.

The problem is that most are turned away because of a severe shortage of
treatment slots.

California's recent passage of Proposition 36, which provides an additional
$60 million this year and $120 million in each of the next five years for
drug-treatment slots, is an encouraging sign. The initiative, however, does
not make any special provisions for pregnant women, so we need to make sure
that their needs are not overlooked.

Drug treatment on demand for pregnant addicts is a policy that anyone who
claims to care about fetal health should support.

The Supreme Court is far from the best forum for such badly needed
pro-active policies. But the refusal of a conservative Supreme Court to
solve the drug problem by creating new criminal sanctions against pregnant
women is a promising step for womenkind.