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Punishment For Pregnant Women

A proposed law would prevent pregnant women from smoking. Could a law requiring women to breastfeed be far behind?
 
 
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In a society that values children, it's striking how frequently our public policy falls short of our rhetoric. Too often, the notion of collective responsibility for the nation's children translates into collective demonization of pregnant women. Collective responsibility for our children should mean support for policies that help pregnant women get the care they need to have healthy babies. Instead, states and localities are increasingly blaming individual women, exaggerating the harms from individual behaviors.

In Arkansas' recent special spring session, Hot Springs Rep. Bob Mathis followed up his successful proposal to make it illegal for someone to smoke in a car with children with a proposal to ban pregnant women from smoking. For those who subscribe to the view that pregnant women are vessels, treating them like cars makes perfect sense.

No one disputes that smoking, drinking and using drugs raise serious health issues for everyone, including pregnant women and their future children. Addressing these health matters, however, through punitive prohibition measures does not work to protect the health of women or the babies they're carrying. Rather, focusing on pregnant women as dangerous people who require special control or punishment inevitably undermines maternal and fetal health. Such measures divert attention from pregnant women's lack of access to health services, and deters them from seeking what little help is available. That is why medical groups including the American Medical Association, the March of Dimes and the American Academy of Pediatrics overwhelmingly oppose punitive measures targeting pregnant women.

Nevertheless, Arkansas Gov. Mike Huckabee supported Mathis' proposal, saying, "A lawmaker's suggestion to prohibit women from smoking during pregnancy makes sense from a health standpoint."

It only makes sense if you haven't bothered to think for a moment about the nature of addiction. Ask Rush Limbaugh, who has by word and deed made clear that addiction -- even for the most popular and economically privileged people -- can be very very difficult to overcome. According to press accounts, Huckabee added that "such a prohibition, if enacted, would probably have to cover other unhealthy activities such as drinking." Perhaps the governor forgot about America's experiment with alcohol prohibition in the 1920s. It failed miserably and there is nothing to suggest that resurrecting it for women only will work any better.

Meanwhile, a county in Alabama is also pursuing public policies that punish pregnant women for their otherwise legal behaviors. Late last month in Franklin County, a woman was arrested and charged with child torture for giving birth to a baby that tested positive for methamphetamine. Never mind that Alabama's legislature has not made it a crime to continue a pregnancy to term in spite of a drug problem or that more than 90 medical researchers warn not to rush to judgment about the potential harms of prenatal exposure to methamphetamine. And just ignore the fact that access to appropriate family drug treatment for pregnant and parenting women is virtually non-existent in this country.

Again, drug use and pregnancy are serious public health issues. But reinterpreting pregnancy as a form of torture and pregnant women as torturers won't help. Drug treatment, access to health care and family support will. It is highly unlikely, however that these services will be provided if the pregnant women and new mothers who need those services are stigmatized as child torturers.

Recent days have also seen a California jury deadlock 6-6 in the case of a woman accused of murdering her infant son by feeding him breast milk containing methamphetamine. What was originally identified as an infant death due to Sudden Infant Death Syndrome became a murder case when prosecutors found traces of methamphetamine in the baby's system. Prosecutors could not even prove the mother breastfed, but they pursued this theory anyway. The mother was convicted at her first trial. The conviction was overturned and the latest trial resulted in the deadlock.

Now let's bring all this full circle. A June 13 story in The New York Times entitled "Breast-Feed or Else" reports that the U.S. Department of Health and Human Services has recently come up with a new, strident pro-breast-feeding campaign. The campaign warns that not breast-feeding may be hazardous to a baby's health and it equates failure to breast feed with risky behaviors like smoking and drinking during pregnancy.

So while Washington launches a government-sponsored breastfeeding campaign built on the premise that mothers who don't breast feed are bad, prosecutors in California have been working hard to portray mothers who do breast-feed as worse, in this case as potential murderers.

These seemingly unrelated events share a common feature -- they all focus attention on pregnant women and mothers as the primary threats to the health and well being of our children. Such a preoccupation with pregnant women stands in stark contrast with a government that allows coal-burning power plants to pour poisonous mercury into the environment with impunity and the 45 million people without health insurance -- including many pregnant women and new mothers who lack coverage for smoking cessation programs, addiction treatment and mental health services.

These disparate interventions and proposals have something else in common. They ensure that pregnant women and new mothers will be at risk of judgment and punishment no matter what they do. It is hard to imagine a worse scenario for anyone serious about improving maternal, fetal and child health.

Lynn Paltrow is the executive director of National Advocates for Pregnant Women.