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Ugh. This is so hard. I do believe the mom should be given a chance. AND I believe there needs to be all sorts of limits and standards. While each case probably requires such individualized consideration. With the child’s needs of safety and comfort and love being at the forefront of it all. It’s dizzying really.

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I don't think drug use in and of itself should have any impact on separating mothers and babies. I don't think mothers should ever be drug tested by the state or required to undergo drug treatment. If there is severe neglect or abuse that happens to be caused (in part or in full) by drug use, then the only concern the state should possibly have is regarding the neglect or abuse. And the bar for separating mothers and babies due to neglect or abuse should be extremely high.

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Does using fentanyl and meth throughout a pregnancy count as neglect?

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Good question. I completely acknowledge the harm that certain drugs, legal and illegal, can do to babies in the womb. I would have a hard time calling using fentanyl and meth throughout pregnancy neglect for the following reasons --

1. Plenty of women take stimulants (analogous to meth) during pregnancy when prescribed by their doctor. I don't believe that a doctor giving it a stamp of approval is the difference between neglect and non-neglect. In fact, I think this deification of doctors is exactly what so many of us women who advocate for home birth, informed consent, medical autonomy, etc., are trying to fight against. I think people would be surprised by how much evidence there is that suggests a low risk of using stimulants during pregnancy (at least certain ones). Now, I'm willing to believe that those who use them without a prescription have a higher chance of using higher amounts & therefore increasing the risk. But this illustrates that the line is really blurred and I don't think the line between "prescribed users" and "illicit users" is actually very meaningful, and it's certainly not meaningful enough to be used as a basis to separate mothers and babies, not even close. I don't know as much about opioids, but this https://www.cdc.gov/pregnancy/opioids/basics.html seems to indicate that at least some women are prescribed opioids during pregnancy. So again, I just don't think that those of us fighting for autonomy from the medical system and the state should be looking for that doctor's stamp of approval to determine whether a mother and baby get to stay together or not. Using certain SSRIs during pregnancy also carries a significant risk for the infant experiencing withdrawal at birth, yet no one ever says that a pregnant woman using SSRIs is abusing her baby -- in fact, many doctors encourage women to continue using SSRIs while pregnant. Now, I think the withdrawal is less severe than it is for high levels of opioid use, so this is part of the reason for the different reaction people have. But I don't think it's the only reason for the difference in reaction. I think part of the reason is because one scenario is embedded in mainstream medical practice and the other isn't, and this leads to bias and motivated reasoning. One woman is "following the rules" and the other isn't.

Obviously there are cases where women are absolute messes during pregnancy, abusing their bodies and creating a situation where their infants are in really bad shape after birth. But I think there are also cases where women illegally use drugs occasionally, casually, and/or to treat problems that doctors would use them to treat, and are treated in horrific ways by the state & medical system. I encourage anyone to read some of the stories of women here: https://www.movementforfamilypower.org/s/MFP-Drug-War-Foster-System-Report.pdf, such as Ms. CS's story starting on page 70.

I'm not saying I think any and all drug use during pregnancy is a good idea and should just be totally accepted. If someone close to me was frequently using drugs during pregnancy, I would probably be concerned, and try to talk to her and research with her the effects of the drugs on pregnancy; and try to support her and motivate her in carrying as healthy a pregnancy as possible -- and if it was severe, I would make my intervention severe, but without using the power of the state and without violating her autonomy and agency. By the way, I'd be much more concerned about her & her baby if she was having two drinks a day than if she was using a moderate amount of unadulterated meth or cocaine once a month.

2. In my view, to preserve societal protection of bodily autonomy, we have to protect pregnant women's rights to full bodily autonomy. This is why I am pro-choice for the entirety of the pregnancy. I know many disagree with that, but that's my personal view. This doesn't mean that I think that it's morally right for a woman to abort a healthy pregnancy at 8 months, or that I would trust a woman who did that with any part of my life. I have to imagine I would see that woman as either deeply broken or extremely off-putting. But I don't think that the state can get involved. For a similar reason, I don't think the state gets to have any involvement with what choices a woman makes about her body during her pregnancy, including if those choices affect the baby living inside. It doesn't mean I always like the outcome, but I think the principle of bodily autonomy is paramount.

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Wow! This is interesting! I am also pro choice for the whole pregnancy! However, dont think women have the moral right to do drugs (including amphetamines or ssris prescribed by a doctor) during pregnancy. (I mean moral right, not legal right, since i dont trust the state with the power to compel women appropriately.) I often wonder about my hypocrisy--how can it be better to kill a baby than to (potentially) harm her? I suppose I see it as weakness to be willing to harm your child but unwilling to decide to kill them.

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This is so hard. I believe in the mom/baby dyad, and I also believe moms can destroy their dyad. The baby's best interest is paramount. No need of a parent is ever, EVER, as great as the needs of their minor child. I THINK I think that a mom who is not making strong efforts to get clean should not be permitted to keep her child's life uncertain and unstable. Meaning her rights should be terminated so that the baby can have a real mother. If motherhood hasn't motivated you to change within the first year, then the baby should permanently stay with the foster mother who HAS been willing and able to change her life for him/her.

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Ah very good point. Just because there’s a dyad doesn’t mean the mom wants to participate in it. Though most would tell you they absolutely do and they all have intention to get clean but … so if the baby is placed in a loving foster care home that wants to adopt. Does time spent outside of the foster home, visiting with a mother who is not sober, is not services, and who will likely lose her rights— is this best for the baby?

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Personally I think a relationship with their biological mother is in the child's best interest, existentially. Most adults would prefer to know their parents than to be in the dark! It will be a comfort to be told they spent time with their mother.

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I lean toward thinking that a gradual "weaning" of visits is probably the best way. Maintain the relationship until it's clear the mom doesn't care enough or is not capable, and then gently end it.

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I dont know enough about these situations to have an opinion! I'd love to hear more of your thoughts, since you are an expert!

I was a drug addict mostly for trauma and maturity related reasons. I was trying to get my shit together already when I got pregnant so I found it easy with the incentive of a baby. However, it is not realistic for a homeless person to be sober. Sobriety follows housing!

I can't imagine having a baby and not being interested in rehab. So I have an instinct that maybe visitation and treatment should be related.

However, I know people who were abused and even assaulted in rehab! I personally have been abused in a psych ward (days after my father's death lol.) So perhaps that is a barrier to seeking treatment.

Also, a baby belongs to their mother, not the state.

But really this is all ignorant speculation. Please write more!

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