Fayne Davis
Mary Beth Ray
Psychology 220
15 April 2012 When Treatment Does Not Work Then Prosecute

The phenomenon of substance abuse during pregnancy has fostered much controversy, specifically regarding treatment vs. punishment. Should the pregnant mother who engages in substance abuse be viewed as a criminal or as someone suffering from an illness requiring appropriate treatment? This diversity of dramatically different responses illustrates the failure to establish a uniform policy for the management of this problem. The issue of substance abuse is one that has negatively plagued society. The complexities surrounding addiction are not easily overcome. These complexities are even more defined in cases of substance abuse by pregnant women, including legal addictive substances such as nicotine and alcohol. This issue has been pushed to the forefront of the public consciousness over the course of the past 30 years. Murphy and Rosenbaum 1999, describe maternal prenatal substance abuse as “chronic use of alcohol and/or other drugs by pregnant women”.

It is my belief that the use of tobacco, alcohol, and illegal drugs during pregnancy is still child endangerment .All these tetatogen’s can kill your baby or cause serious problems for them with the development of cognitive, physical, social, and emotional abilities. It is unfair to the child to have no control over what has caused them problems with development as a result of their mother’s teratogen use; therefore there should be consequences as a result of their harmful decisions.

It is understood that a women has the right to do with her body what she wants and that some that are pregnant: drink, smoke, or use illegal drugs with no signs of birth defects apparent in the born fetus. In addition, I do have compassion for those addicted to drugs that may require rehabilitation to both remain clean and develop the positive parenting skills necessary to raise a healthy child. What about the unborn fetus? I believe the welfare of the potential child should be considered first and foremost before anything else. It is important for mothers to be to understand that their blood flows through the placenta into the fetus’s veins to the umbilical chord. The placenta then acts as a filter, but it does not protect against the transmission of harmful substances such as nicotine, alcohol, or illegal drugs. When pregnant women show compassion for the welfare of the unborn child there is a better chance for a safer birth and less complications as a result. Therefore, there should be laws in effect to give the unborn fetus the best opportunity possible for an equal chance for development. An opportunity should be given for treatment for those using legal substances such as nicotine or alcohol, with an emphasis on education about the potential harmful effects of their actions. Those pregnant mothers that are using illegal drugs should be sent straight to detention and the baby placed in childcare facilities during treatment and incarceration. Those who do not comply should suffer the consequences of their decisions in a family court setting. One of the problems with these requirements is that Doctor’s would be held accountable for these pregnant mothers. Development is effected in many ways by the use of the aforementioned teratogen’s by pregnant mothers. As I mentioned before, if the fetus survives birth there may be emotional, physical, cognitive, or physical developmental problems. I will demonstrate these proven problems using examples from our text (Lifespan Development-Infancy-Adulthood) and other scholarly sources. By doing so, a better understanding will be gained about the effects of use within each of the categories: smoking, drinking, and illegal drug use (with a concentration on heroin and cocaine) by pregnant mothers. They need to understand that the fetus is a part of them and not a separate entity. It is also very important for pregnant women to understand the dangers of two legal substances that are harmful to fetus: alcohol and nicotine. With regards to alcohol use, (Sternberg et al., 2011) points out that alcohol does have addictive substances that alter mood and body chemistry. According to Kenneth Lyons Jones and colleagues 1973, within Sternberg (FAS) fetal alcohol syndrome found in babies with alcohol abusing mothers have identifiable facial deformities and mental disabilities that are apparent. In addition, FAS is the most known cause of mental retardation. These babies are small at birth and usually do not catch up with their peers as they grow older. FAS babies are born with small heads and distinctive facial features, including a low nasal bridge, thin upper lip, narrow forehead, and small eyes (Ashley & Claren 1996, within Sternberg et al.). Bertrand, Floyd, & Weber 2004, within Sternberg et al, point out that these unfortunate babies also have: a short attention span, and emotional and behavioral disorders. In addition, problems are not limited to cognitive disabilities, and are apparent with the development of high rates of criminalized and sexualizes dysfunctional behavior, depression, suicide, and parental neglect of children (Kelly, Day, & Streissguth 2000, within Sternberg et al.). Further evidence about the dangers of alcohol consumption during pregnancy come from a Canadian study in which Woodard 1998 finds that: "The fetus' physical development may be out of danger after 12 weeks' gestation, but the developing brain is vulnerable all through a pregnancy", says Dr. Brian Lowry of the Alberta Children's Hospital in Calgary. Lowry adds that anything more than an occasional glass of wine is considered dangerous and that the best measurement is to abstain from alcohol completely during pregnancy to be sure there are no complications. Now I will discuss the dangers associated with nicotine use during pregnancy. Sternberg 2011 finds that women who smoke during pregnancy have a higher risk than non-smokers for miscarriage, preterm deliveries, and small, low-birth-rate, and otherwise compromised babies. The March of Dimes (2008) within Sternberg et al. points out that: stillbirths would be reduced by 11 percent and newborn deaths by 5 percent if all pregnant women stopped smoking. This organization also implies that mothers who continue to smoke after delivery increase the rates of respiratory illnesses such as: bronchitis and pneumonia, and ear infections, as well as an increased risk of developing asthma. With all of this evidence of the dangers of smoking during pregnancy, limitations should be put on expectant mothers. Unfortunately, many mothers believe that it will not happen to their child. Further evidence noted in The Brown University Digest shows that 59 percent of pregnant mothers who had a child that suffered with ADHD (Attention Deficit Hyperactivity Disorder) were smokers. In addition, researchers found that mothers who smoked had three times the risk of bearing a child who suffered with (ADHD). These problems are considered to arise from the chemically altered dopamine levels that are important for normal brain development in a fetus. This is another reason for the pregnant women to understand the importance of the connection between herself and the unborn fetus. Now that I have discussed the 2 legal substances of harm to the unborn fetus, I would like to discuss the harmful effects of the 2 most dangerous illegal drugs: heroin and cocaine. I will begin with heroin. Steinberg et al. 2011 points out babies born to heroin addicts are addicted as well. These babies suffer tremors, vomiting, diarrhea, sleep disturbances, and irritability. What is disturbing to me is these babies suffer through these withdrawal symptoms within 1-3 days of birth. The most shocking result is that if there mother has injected the heroin the babies are at risk for the contraction of HIV. In addition, (Batshaw & Conlon, 1997 within Steinberg et al.) show evidence of later problems associated with heroin addicted babies. These researchers define these problems as: lower IQ, attention disorders, and behavioral problems, and an on-going exposure to the drug culture. In a retrospective analysis study of 40 infants born to heroin addicted mothers, Reddy et al. (1971) found that 85percent developed withdrawal symptoms consisting of central nervous system, gastrointestinal, and respiratory disturbances. In addition, these researchers found that tolerance, even in utero, had developed. More than half were small for their gestation age, and morbidity rates were high. This research shows the suffering and death associated with using heroin during pregnancy on the baby. It is time to discuss the drug that I feel is the most devastating illegal drug to the unborn fetus and those that are successfully birthed. Steinberg et al 2011 points out that cocaine has devastating effect on the fetus and newborn in both the short term and on the developing child and adolescent in the long term. This is mainly because cocaine is a central nervous system stimulant that interferes with the reabsorption of neurochemicals associated with pleasure and movement. Because cocaine passes quickly from the mother to the fetus, use increases the risk of miscarriage, stillbirths, and premature births. In addition, prenatal exposure has been linked to low birth weight, small head circumference and length, irritability, hypersensitivity, and lack of muscle and mood control. Another factor of cocaine use is that it has been associated with (SIDS) sudden infant death syndrome. This is an unexplained death, usually during the night, of an infant under 1 year of age (McKenna et al. within Steinberg et al.). In a developmental study (Mayes et al. 1993 within Steinberg et al.) found that infants exposed to cocaine in utero scored low on tests designed to measure reflexes, motor skills and responsiveness at 3 and 6 months of age. A shocking 40 percent of babies born to cocaine abusing mothers who were still using after the baby was born showed IQ scores below 85 (Scherling 1994 within Steinberg et al.). Schutter and Brinker 1992 from the University of Illinois Chicago found that 10-30 percent of pregnant mothers used cocaine during pregnancy. The disparity is a result of hospitals not performing routine toxicology reports and women unwilling to report use for fear of consequences. They describe the effects on the fetus as “the peripheral mechanisms as the anesthetic effect of cocaine achieved by the capacity to block the return of neural cells to a resting electrical potential after the cell has fired”. They add that the effect is the basis for the damage to the heart, circulator origin to the brain, or rupture of underdeveloped vascular systems in the developed fetus. As a result, anoxia (an absence of oxygen carried in the blood) or ischemia (tissue anemia) in the developing fetus are concerns for cocaine using pregnant women. These findings further demonstrate the need for education to those that have substance abuse problems to help in the prevention of childhood and later development issues. After considering all of the evidence about the harmful effects of these substances on the unborn fetus, my first impression was to side with the thought that all substance abusing pregnant persons should to be prosecuted. It seemed to me that every pregnant person should be compassionate enough to control their behaviour to enable an unborn fetus to have an equal chance at development and a healthy life. Looking at the big picture affords me the opportunity to look at all sides of this issue and make a well informed decision regarding the debate of treatment versus prosecution. My decision was to side with a treatment opportunity in the family court system. The main reason I decided to go that way was that I found that 75 percent of women involved with a substance abusing situation were at one time abused themselves as a child and 25 percent had some form of a mental disability. In addition, many of these pregnancies are a result of sexual abuse by a family member, an unexplained attack from a sexual predator, or someone that comes from a dysfunctional family system or one that is socioeconomically challenged. These individuals have not developed the knowledge or skills to prevent them from stopping their destructive behaviour on the fetus. The family court system affords these drug using individuals an opportunity at rehabilitation or jail, and most importantly another chance to keep the child with them in the family system. Outcome research has shown a significant decrease in drug use by participants once they enter the program with 95% showing negative drug tests

Works cited ADHD in children born to smoking mothers. DATA: The Brown University Digest Of Addiction Theory & Application [serial online]. September 2005;24(9):9. Available from: Academic Search Complete, Ipswich, MA. Accessed April 15, 2012.

Murphy S, Rosenbaum M: Pregnant women on drugs: Combating stereotypes and stigma. New Brunswick, NJ: Rutgers University Press; 1999. Reddy A, Harper R, Stern G. OBSERVATIONS ON HEROIN AND METHADONE WITHDRAWAL IN THE NEWBORN. Pediatrics [serial online]. September 1971;48(3):353. Available from: Academic Search Complete, Ipswich, MA. Accessed April 15, 2012 Schutter L, Brinker R. Conjuring a new category of disability from prenatal cocaine exposure: Are the infants unique.. Topics In Early Childhood Special Education [serial online]. Winter92 1992;11(4):84. Available from: Academic Search Complete, Ipswich, MA. Accessed April 15, 2012.

Woodard J. Sins of the mothers. Alberta Report / Newsmagazine [serial online]. February 23, 1998;25(10):31. Available from: Academic Search Complete, Ipswich, MA. Accessed April 15, 2012.