MOTHERSTOBE NEED HELP, NOT FEAR, CRITICS SAY

By Brian Maffly, The Salt Lake Tribune        

Everybody agrees pregnant women should not abuse drugs or alcohol because
it puts their fetuses at risk for a lifetime of physical and mental problems.

    But in the wake of a felony child abuse case filed against a Tooele
mother, it is clear that opinions differ on how society should deal with
this public health scourge.

    Julie Garner, 26, was charged last month after she gave birth to a
sickly child following a pregnancy allegedly filled with alcohol abuse.

    Last Monday, 3rd District Judge L.A. Dever freed Garner, who had been
in jail for six days on $10,000 bail, and set a preliminary hearing for
Jan. 14. Garner, the second Utahn charged for socalled ``fetal abuse,''
could face up to 5 years in prison if convicted of the thirddegree felony.

    Deputy Tooele County Attorney John Bybee says the case could deter
other expectant mothers from substance abuse because they could be held
criminally accountable.

    ``Mr. Bybee doesn't understand alcoholism,'' responds Garner's mother,
Valerie Stechschulte. ``There's a huge difference between a criminal and a
person who is ill. Alcoholism is a disease. Fear is not going to help these
people. Alcoholics don't drink to harm their children.''

    Critics like Stechschulte contend the threat of prosecution more likely
would deter addicted mothers from seeking treatment out of fear of going to
jail or losing custody of their child.

    ``What will protect them from being turned in when they show up for
prenatal care?'' says Louise Melling, an attorney with the American Civil
Liberties Union's Reproductive Freedom Project. Civil libertarians also
fear that ``fetal abuse'' cases are backdoor attempts to extend the legal
status of fetuses at the expense of mothers' rights.

    Many observers say that if Utah leaders are truly concerned, they
should support programs to prevent prenatal substance abuse, an effort that
requires outreach and education.

    ``If Utahns put their money where their priorities are, we would have
had a good chance to give this woman [Garner] the support she needed to
understand what she was doing,'' says Roz McGee, executive director of Utah
Children. ``It's investing [in prevention], not just lip service.''

    Several states began prosecuting prenatal drug use during the height of
the crack epidemic in the late 1980s, when drugexposed babies created a
highly visible publichealth crisis. Prosecutors used traditional child
abuse and drug trafficking statutes to win a handful of convictions, most
of which were thrown out on appeal because these laws were not intended to
protect fetuses.

    But Utah did not join this criminal justice experiment until last year
when Salt Lake County prosecutors charged a drug dealer with child abuse
after her baby girl was born with controlled substances in her system.

    The subsequent conviction of Kim Hoskins of West Valley City is one of
the few fetal abuse convictions on the books, but the Hoskins case sets no
legal precedents because she declined to appeal. She is serving up to 15
years in prison on her drug convictions and a concurrent 5year term for
child abuse.

    Unlike Hoskins, who used cocaine and methamphetamine while pregnant,
Garner's underlying vice is legal. Third District Court records contain no
criminal background except for traffic offenses, including a drunken
driving conviction.

    ``She has a sweet and loving nature,'' her mother says.

    Garner's father abandoned the family when she was 9 years old, and
Stechschulte says she had little time for her children while she returned
to school and worked to support them. Garner took up drinking when she was
15 and by the time Stechschulte found out, her daughter had a problem.

    The unmarried Garner has an 8yearold son, who lives with his father.
She became pregnant early this year, but Stechschulte does not know who the
father is.

    Prosecutors say Garner's baby girl was born full term at a tiny 2
pounds. The child spent nearly a month in intensive care before the state
Division of Child and Family Services placed her in a foster home.

    Stechschulte, who is fighting to gain custody of her granddaughter,
contends the baby weighed in at 2 pounds, 9 ounces and was born a week shy
of full term.

    Prenatal exposure to illegal drugs has been linked to low birth weight
and respiratory and neurological problems in children, but the connection
remains tenuous.

    Alcohol, however, has been so exhaustively implicated in birth defects
that a disease is named after it: Fetal Alcohol Syndrome. This malady
afflicts about 10 percent of children born to chronic drinkers, while
another 40 percent may suffer adverse effects of alcohol exposure, says
developmental psychologist Barbara Morse, who heads the Fetal Alcohol
Education Program.

    Binge drinking, particularly late in the pregnancy, is more likely to
cause FAS than regular, but more moderate imbibing, Morse says. The
disorder leaves children developmentally disabled.

    ``The greatest risk is in the third trimester, when the brain is
developing,'' she says. ``That's why treatment can be effective.''

    Diagnosing FAS is difficult during the first year of a child's life,
although newborns sometimes exhibit signs and facial characteristics
consistent with the syndrome, according to Morse. Extremely low birth
weight, as was the case with the Garner child, is not necessarily an
indicator.

    ``You have to ask yourself what other reasons there are why a baby
would be that small,'' Morse says.

    Morse and others point out that other lawful activities have been shown
to be harmful to the unborn. If authorities criminalize prenatal drinking,
why not target expectant mothers who smoke tobacco, diabetics who fail to
take insulin or parents who have children despite a known genetic
predisposition for birth defects, asks Lynn Martinez, a Utah public health
official who specializes in highrisk pregnancy.

    Prenatal care is a better use of resources than punitive actions if the
goal is to help the expectant mother avoid risky behavior, Martinez says.
In Salt Lake County, the House of Hope program provides substance abuse
treatment for women, including pregnant women and mothers with children.
Some of its clients are ordered into the program by state childprotection
officials.

    ``It's a more viable option than incarceration,'' said the program's
executive director. ``They receive parenting skills, vocational
preparedness, relapse prevention.''

    The Utah Alcoholism Foundation operates the program on a county grant.