Pregnant Drug Users Afraid of Help

Pregnant women with drug problems are shying away from prenatal care for
fear they will lose custody of their children, say local counselors and
treatment experts. In fact, Lynn Martinez, program manager for the
Pregnancy Risk Line at the Utah Department of Health, said this year and
last have brought in the lowest number of calls since the program began 15
years ago. "We're probably getting about half the number of calls we are
used to," she said. Though the state has not charged a substance-abusing
pregnant woman with felony child abuse since January 1998, Martinez and
some of her colleagues said women are scared of getting in trouble.

"I have patients who are methadone users, so they're out there," said
Donald Dudley, and obstetrician specializing in high-risk cases at
University Hospital in Salt Lake City. Methadone is a regulated narcotic
used to wean addicts off of heroin.

"But I think there is a lot of fear out in the community about this issue.
A lot of them have been driven underground," Dudley said. Martinez and
others at the health department refer women -- including those who use
drugs -- for prenatal care. Physicians and drug rehabilitation centers on
the agency's list have wondered why the referrals are dropping. "I've been
calling everyone I know asking where these women are and they've all
noticed a decline," said Martha Wunderli, community services director for
the Highland Ridge Hospital rehabilitation center.

In fact, the numbers are so low at Highland Ridge that the center still has
money left over from county funds that pay to treat pregnant drug users.
Martinez, who chaired 1991's state task force for Maternal Drug Use and
Drug Exposed Infants, thinks doctors' incorrect belief that a positive test
for substance abuse must be reported to the state has some women running
scared. "There is no legal requirement in Utah that people be reported if
they are a substance abuser and are pregnant," she said.

A state Maternal Drug Use/Drug Exposed Infants Task Force, which Martinez
chaired, recommended in 1992 that prosecutions be avoided for fear of
frightening women away from treatment.

"What we're seeing is what we predicted in the task force report," Martinez
said. Since 1996, four pregnant women in Utah have been charged with felony
child abuse. One pleaded guilty, one pleaded no contest.

Charges against the other two were dropped.