Drug Treatment Slots Are Scarce For Pregnant Women : Shots - Health News The state's "fetal assault" law punishes women whose babies are born with drug withdrawal symptoms. Proponents say the law spurs women to seek treatment, while opponents say it deters them.
NPR logo

Listen to part one of this story

  • Download
  • <iframe src="https://www.npr.org/player/embed/455924258/456541314" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript
In Tennessee, Giving Birth To A Drug-Dependent Baby Can Be A Crime

Listen to part one of this story

  • Download
  • <iframe src="https://www.npr.org/player/embed/455924258/456541314" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript

ARI SHAPIRO, HOST:

In the United States, a baby is born dependent on drugs every 30 minutes. Tennessee has a rate three times higher than the national average. So the state decided to charge those mothers with a crime. Lawmakers call it fetal assault. Other states are considering similar laws, and I wanted to find out what the impact has been in Tennessee. So I teamed up with somebody who knows this story well - Blake Farmer, reporter with member station WPLN in Nashville. Hey, Blake.

BLAKE FARMER, BYLINE: Hello, Ari.

SHAPIRO: You reported on this law when it was being debated a year and a half ago. And just the other day, we met up in East Tennessee.

FARMER: Yeah, and as I was driving east from Nashville to meet you, I saw this billboard by the interstate. It said, your baby's life shouldn't begin with detox. These messages with pictures of infants are strategically plastered in places with some of the biggest problems - places like Oak Ridge. This is a town surrounded by poor, rural areas. This is Appalachia. Addicts here use prescription painkillers, heroin and other drugs.

UNIDENTIFIED WOMAN #1: Oh, you're going to drool on me. You're going to drool on me. Oh, you got to throw up? Don't do that.

SHAPIRO: We're at a group called MIST, Mothers and Infants Sober Together. A bunch of women sit in a circle, some of them with their babies, some recently out of prison. They give each other advice and support.

UNIDENTIFIED WOMAN #2: I'm actually doing pretty well with the medication. I haven't used since then.

UNIDENTIFIED WOMAN #3: Yeah, can I say something? Don't feel guilty about taking Suboxone right now because it's going to help you...

SHAPIRO: There's been a fair amount of reporting on this fetal assault law, but the stories almost never include these voices, the mothers. They opened up to us. They told us they want people to know what's happening.

FARMER: One of the women I talked to was named Brittany Crowe. She told me when she found out she was pregnant, she kind of panicked. She knew that if she went to the doctor and she took a drug test, it would come back positive.

BRITTANY CROWE: The new law that had came out scared me, so I was afraid to get help.

FARMER: She had no prenatal care.

CROWE: None whatsoever.

FARMER: Finally, she went into labor, rushed to the hospital and gave birth in 10 minutes. The state took her newborn and her older kids and put them into foster care. Now she thinks back on the decisions she made.

CROWE: I didn't want to go to the hospital. I worry about that a lot now. I wonder how many babies, you know, they're not known about because the mothers are afraid to get help. And then they're born at home, and nobody ever knows about these babies. I mean, if they're going through withdrawal so bad, they're going to pass away. And, you know, people's not even going to know about them because the mother was afraid to get help.

SHAPIRO: One of the things that most surprised me at this group was the number of women who believe the law is a good motivator. Jessica Roberts got pregnant and she was afraid of the law, so she went to rehab twice. Both times, she relapsed, injecting herself with opiates. Finally, she was in her third trimester getting ready to give birth to a little girl.

JESSICA ROBERTS: What finally broke me was I was 31 weeks. I had tied off to hit myself, and I put my arm on my stomach, and she kicked my arm off. And that broke me. To me, it was like my baby saying, Mom, you know, you can't do this anymore. I need you. And it hurt.

SHAPIRO: It is really hard to know whether this law is driving mothers to get help or scaring them away from it. People who work on this problem in Tennessee tell us they feel like they are drowning in addiction and nobody has thrown the state a life preserver. Michelle Jones is a social worker who runs this organization. She sits in the circle with these women encouraging them to open up.

MICHELLE JONES: I don't necessarily believe that fear is the way to work with this because these women were so afraid. We're looking at fear and judgment, but then when you put a law in place that says, well, we could criminalize you, that doesn't help, that just increases fear and judgment that these women are already facing.

FARMER: Unless the state legislature renews this law, it expires next year. And that's one reason people are paying so much attention to how it's working so far. Some prosecutors here in Tennessee, they refuse to enforce the fetal assault law. One man who's used it a lot is Barry Staubus. He's the district attorney for Sullivan County in the remote northeast corner of the state. He's prosecuted more than 20 drug-using mothers just this year.

BARRY STAUBUS: And as much as I care about the mothers and want to help them, I also care about the babies who never had a choice, who never had a say-so in if they're born on drugs, that never have a say-so on all the impairment and all the disability they may experience because the decision by their mother that they could not give voice and oppose.

SHAPIRO: Since the law took effect last year, the number of babies born having drug-withdrawal symptoms has not gone down. I visited the neonatal intensive care unit at Vanderbilt Hospital in Nashville. This is what it sounds like when a 1-week-old baby goes through drug withdrawal.

(SOUNDBITE OF BABY CRYING)

SHAPIRO: Dr. Stephen Patrick specializes in neonatal abstinence syndrome. He saw a hundred cases here last year. This year, they're on track for at least that many. Still, he doesn't think punishment is the right focus. He says the country overreacted to crack babies in the 1980s, and the same might be true here. It's not clear that babies going through drug withdrawals as newborns will suffer 10 or 20 years down the road.

STEPHEN PATRICK: The evidence really doesn't support that for neonatal abstinence syndrome. And in fact, we know that other substances, legal substance such as alcohol, are far more harmful long-term to infants.

SHAPIRO: This is not just a Tennessee story. Alabama has a similar law and several other states are considering one. Amnesty International's preparing a report about this law. They fear the criminal justice system is getting involved in what's really a healthcare problem.

FARMER: Each new mother we meet in Tennessee is fighting her way back to normalcy day by day.

CROWE: Matthew, James and Jacqueline, come here.

FARMER: Brittany Crowe is the woman we met earlier who received no prenatal care and then lost custody of her children. Now, her youngest is 9 months, perched on her hip. He has big, blue eyes and a tuft of blonde hair. Her older kids are playing in a stream.

SHAPIRO: She's been through a lot to reach this point.

Let me just ask what it is like for you to be here with your kids, seeing them play with each other in the park?

CROWE: It's wonderful. I can honestly say a year ago, I wouldn't have been.

SHAPIRO: One of the boys runs up with a bottle full of muddy water from the stream.

(LAUGHTER)

SHAPIRO: Oh, you got mama all wet. Oh, no. Well, I guess this is what you signed up for, huh?

CROWE: Yeah, I guess so (laughter).

SHAPIRO: Brittany Crowe just graduated from the support program. She has a new job and her kids. This is a woman who found the help she needed.

Copyright © 2015 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.