Misconceiving Mothers: Legislators, Prosecutors, and the Politics of Prenatal Drug Exposure, by Laura E. Gomez (Philadelphia: Temple University Press, 1997), 207 pp., $59.95 (cloth), $19.95 (paperback).
Pregnant Women on Drugs: Combating Stereotypes and Stigma, by Sheigla Murphy and Marsha Rosenbaum (New Brunswick: Rutgers University Press, 1999), 204 pp., $49.00 (cloth), $19.00 (paperback).
On May 26, 1998, the United States Supreme Court refused to bear an appeal by two low-income African-American mothers of a South Carolina Supreme Court decision imprisoning them for cocaine use during pregnancy, despite the safe births of their healthy babies, Whitner v. State of South Carolina.1 These two women were incarcerated, sentenced to eight- and five-year terms of imprisonment, respectively, and forcibly separated from their children. They and their children are trapped in the intersection of anti-abortion political activity, the war on drugs, and the war on poor women. For the first time, the state court decision in Whitner found that the criminal child-endangerment statute applied to viable fetuses, and therefore to the conduct of pregnant women. As a result of this decision, and because of a state law requiring health treatment providers to report suspected child abuse, any woman who is in the later stages of pregnancy and using drugs must be reported by any health treatment provider, including drug treatment providers, she consults in South Carolina. South Carolina's drug treatment programs have experienced "precipitous drops in admissions for pregnant women" of as much as 54% to 80%, depending on the facility.2
Although South Carolina represents the most extreme situation, over 200 women across the country were prosecuted for drug use during pregnancy between 1985 and 1995.3 Most of those prosecutions were ultimately dismissed, but they have had a chilling effect on pregnant women's going for drug treatment. A national survey of state directors of substance abuse services in 1995 found that earlier policies of expanding treatment for addicted women were being replaced by cuts in services and by increased state intervention.4 Other studies have demonstrated the racially disparate nature of the response to drug use during pregnancy, with women of color disproportionately likely to be reported by health care providers to child welfare authorities.5
The two books reviewed here, Misconceiving Mothers: Legislators, Prosecutors, and the Politics of Prenatal Drug Exposure and Pregnant Women on Drugs: Combating Stereotypes and Stigma, present different, and critical, pieces of the picture on pregnant women and drug use. Both begin by describing the media frenzy about "crack babies" that developed in the mid-1980s based on a handful of poorly designed, now generally discredited studies. Both also discuss the current scientific disputes as to whether there is a causal link between cocaine use and serious fetal harm. (In contrast, the potentially harmful effects of alcohol and tobacco use during pregnancy are very well documented.) Much of the current scientific evidence points to lack of high-quality prenatal care, rather than cocaine use, as the most critical problem.6 The two books then diverge, with Misconceiving Mothers focusing on political insiders and their decision-making processes and Pregnant Women on Drugs focusing on the women whose behavior is at issue.
Laura Gomez's study, Misconceiving Mothers, clearly and articulately describes three related processes in California: the development of "crack babies" as a topic in the media and the subsequent institutionalization of pregnant women's drug use as a social problem; the 1983-1996 political battle in the state legislature over lawmakers' response to prenatal drug exposure; and decision-making by local district attorneys on whether or not to attempt prosecutions of women for drug use during pregnancy. Gomez interviewed legislators, advocates and lobbyists, and prosecutors. …