THINK PRENATAL CARE, NOT JAIL, DOCTORS URGE

Women who use alcohol or drugs while pregnant should be sentenced to
prenatal care, not to jail, say medical experts.

"You can take them out of their environment," said Dr. Milton Lee, a Los
Angeles physician, "but the problem is ... what happens when they go back."

Lee and others who work with substance-using mothers and their children
shared that anti-incarceration sentiment Tuesday at the 11th annual
Families, Babies and Drug Conference in Modesto.

Health professionals made presentations to an audience of about 375 at the
DoubleTree Hotel. The presenters included a Modesto family practice doctor
who uses rap music to teach children about good health.

Speakers focused on topics relating to the use of drugs, tobacco and
alcohol, and the short- and long-term effects on pregnant women, mothers
and their children.

One recurring issue concerned whether to treat substance-abusing expectant
mothers as criminals. It is a practice carried out in some courts across
the country, and speakers at the Modesto conference said they believe it is
a bad idea.

"Jail is a bad place for a pregnant woman to be," said bioethicist and
attorney Lawrence Nelson, who gave a 90-minute presentation titled, "Unwise
Public Policy: Criminalizing the Pregnant Substance Abuser."

Nelson outlined the problems he sees with jailing substance users:

* The practice is inconsistent. Women who smoke cigarettes or drink are
rarely, if ever, punished, since tobacco and alcohol are legal. Of the 200
cases prosecuted in 30 states, all have involved illegal drugs.

"It's arbitrary," Nelson said. "How can we turn a blind eye to alcohol and
nicotine?"

* Minorities make up a disproportionate number of the women who are
prosecuted.

* To enforce it, health providers would have to turn in their patients.
That in itself would discourage substance users from seeking medical care.
"If they think they will get into trouble, they will get less prenatal
care," Nelson said.

Instead of punishment, substance users need treatment. Lee said addicts who
receive prenatal care while pregnant can improve their fetus' outcome after
birth.

Other speakers were Susan Doctor, an associate professor at the University
of Nevada at Reno, and Dr. John McCarthy of the University of California
Medical Center in Sacramento.

Discussion also centered on fetal-alcohol syndrome, and the use of
clinically prescribed methadone to help pregnant women addicted to opiates,
such as heroin.