see attachments
As you may know from reading the textbook, exposure to teratogens is often beyond a pregnant women's control- or even her knowledge. However, one controversial issue related to this is how to address substance and/or drug use by pregnant women.There are many factors to consider, but please first read the short article for some background on this matter. This author is focusing primarily on legal aspects in Canada. However, she raises issues about illicit drug use as well as substances that may be legal- but have some adverse effects on the baby . Questions 1. How should the issue of illicit drug use and pregnancy be handled? Is there any reason to consider legal sanctions? What other methods can be used to reduce risks of such teratogenic harm to a developing child? What factors should be taken into account? 2. Consider also the use of legal substances and pregnancy (smoking, drinking, taking aspirin or other medications without medical advice). How might these issues be addressed? 3. When considering both these matters, should drug testing be mandated? If so, for which drugs? Should women who are found to be using illicit drugs be prosecuted? or what? What is the ethical position here? I would note that textbook authors D. Boyd and H. Bee (Lifespan Development, 3rd ed, 2003; Pearson), point out that there are many issues to consider when pondering legal or social sanctions as far as drug use and pregnancy. For example, according to those authors, drugs that pass through the placenta cannot always be detected in the newborn. On the other hand, some substances pass through the baby so quickly that drug testing would be meaningless unless completed right after birth. 4.What kinds of programs, sanctions or guidelines might you want to see in place to minimize harm to developing babies? As noted, in the past, this has been a "hot button" issue. Please read the article and formulate a position about this, using evidence from your book, from the attached reading and/or any suitable research you wish to cite. Again, please show respect to those you may disagree with - you may provide evidence to counter an argument, but do so politely please! WOMEN AND ILLICIT DRUG USE *1 WOMEN AND ILLICIT DRUG USE *1 Written by Susan Boyd WOMEN AND ILLICIT DRUG USE *1 Susan Boyd examines the impact of the medical and social service professions and drug legislation on women who use illicit drugs. : INTRODUCTION Conservative researchers are quite biased and favour stringent legal sanctions whereas liberal researchers offer logical arguments that appear to present both sides of the issue. Neither conservative nor liberal paradigms offer solutions for underlying problems associated with class, sex and race. Preliminary findings drawn from field work and 25 semi-structured, open-ended interviews with adult women who have used illicit drugs in Canada will inform this paper. All the women interviewed were mothers. The interviews were conducted outside a prison or clinic population, and all participants were assured confidentiality and anonymity. WOMEN AND ILLICIT DRUGS - Researchers have constructed negative images of deviant mothers who use illicit drugs (Rosenbaum et al., 1990; Taylor, 1993). Mothers have been portrayed as sexually promiscuous, lacking maternal instincts, uncontrollable and at risk to their children. Until the 1970s there was little discussion about women who used illicit drugs; critical research tended to concentrate,'on the man about town' rather than the 'women at home with the kids' . Consequently only two ethnographic studies of female illicit drug users exist: Marsha Rosenbaum's (1981) groundbreaking study of female heroin users in San Francisco and, more recently, Avril Taylor's (1993) study of women injectors in Glasgow. Both are written from the women's perspectives and contribute to a fuller understanding of women who use illicit drugs. In contrast to the negative images projected in much research, Rosenbaum (1981) and Taylor (1993) noted that the women they interviewed shared dominant parenting values. Preliminary findings from the Canadian inter views complement those of Rosenbaum and Taylor in relation to parenting values. This research also high lights the diverse nature of women who use illicit drugs - diverse in age, race and class. Aside from their status as mothers and their use of illicit drugs, they were not homogeneous. Moreover, Canadian women who use illicit drugs, especially women of colour and poor women, are often denied the chance to mother their own children because the diagnosis of neonatal abstinence syndrome (NAS) and suspected maternal drug use are often grounds for social service intervention. Mothers are also separated 1 / 9 WOMEN AND ILLICIT DRUG USE *1 Written by Susan Boyd from their children when incarcerated for narcotic or related offences. However, the consequences of their illicit drug use are mediated by social status in society, one's race, class, sex, the social economic environment, the law, social services and the medical community. The law Women who use illicit drugs are subject to arrest, because the possession of narcotics is a criminal offence in Canada. However, the question of which drugs are legal or illegal is historical, cultural and political; the division separating licit and illicit drugs is a socially constructed phenomenon. There is no universal consensus on what is a drug and which drugs are dangerous. Although Canadian narcotic laws have become more severe since the initial legislation to criminalise substances in 1908, the use of illicit drugs has not been curtailed (Alexander, 1990; Boyd, 1991). In Canada, criminalised women tend to be single, though many have dependent children (Chunn and Gavigan, 1 99 1 ), poor and young; often they have histories of drug and alcohol abuse (Siirnpson,1989). Women comprise about 13% of all adults charged under federal drug legislation (Single et al.,1994, p. 260) . For pharmaceutical drugs, women accounted for nearly a third of all convictions in 1990 (Health and Welfare Canada,1991, p. x). In addition, Faith also notes that 'increasing numbers of women of African heritage, from the U .S . and the Caribbean, are serving time' (1993,p.184) at Kingston (P4W),Canada's federal penitentiary for women, for importing and trafficking convictions. Furthermore, First Nations*2 women are over-represented in the criminal justice system (LePrairie,1987), and sentenced to custodial care (41.2% ) more than white women (25.7% ) (Masson,1992). Although legal policy affects both men and women, men are not subject to recent legal sanctions against pregnant women who may have used illicit drugs in North America which have culminated in what feminists term 'the criminalisation of pregnancy'. Discourse centres on suspected fetal harm and, in the USA, legal charges of trafficking to the fetus, manslaughter, child abuse and infant neglect have been brought against pregnant women suspected of illicit drug use. Illicit drug use is suspected, because urine analysis, the primary form of drug testing, is unreliable. Furthermore, Humphries et al. (1992) discuss the race and class bias associated with drug testing in the USA, as well as the fact that drug testing can only tell what drugs were used within the last 24-72 hours (pp. 90,213). Drug testing cannot distinguish the dependent, occasional or first time user. Most: important, drug testing cannot determine whether an infant will be adversely affected by its mother's drug use. On appeal most of these charges have been dropped, though women were subject to house arrest, incarceration and separation from children. The criminalisation of pregnancy brings up larger concerns in respect to women's rights, and reproductive autonomy diminishing in lieu of fetal rights. Feminists conclude that the criminalisation of pregnancy, and emerging fetal rights (Humphries et al.,1992; Maher, 1992), 2 / 9 WOMEN AND ILLICIT DRUG USE *1 Written by Susan Boyd have culminated in a situation where the well being and security of women's bodies is legally and physically challenged (Oakley, 1984, Gallagher, 1989). Social services In the USA, Maher (1992) notes how welfare policy intersects with criminal justice controls and 'functions as an independent and gender-specific form of punishment and regulation' towards women (p.158) . Maher examines how women who use crack cocaine in the USA are regulated and controlled through administrative law and welfare policy. In Canada, many women who use illicit drugs also come into contact with social services. Intervention and apprehension of children can play as much of a role as the criminal law in regulating poor women. Middle-class women interviewed in Canada were less fearful and had less contact with social services. For middle-class women, the law and the fear of arrest were primary, especially if they or their partners were dealing or transporting large quantities of illicit drugs Poor women who use illicit drugs are often challenged by social services in relation to their mothering. In Canada, many social service professionals equate illicit drug use with poor mothering which places children at risk. Many poor women have had their children apprehended temporarily or permanently, and placed in foster care. Of the Canadian children in care, First Nations children are over represented. Although First Nations people represent less than 4% of the total population in Canada, Monture (1989) found that, in the province of British Columbia,39% of children in care are First Nations and this rate is higher in the prairie provinces (p.2) Monture (1989) defines the welfare system in Canada as an extension of the criminal justice system for First Nations people, because both punish people by removing them from their families and communities. In addition, this has had devastating effects on the traditional structure of the family and community, similar to the removal of First Nations children to residential schools in the past. Preliminary findings from the Canadian interviews note that many of the women interviewed were poor, and over 25% were First Nations. Many were raised in foster care and their own children are now in care. Several women had their children apprehended at birth after being diagnosed with neonatal abstinence syndrome. Thus, the cycle continues. As mentioned above, not all women who use illicit drugs come to the attention of social services. Middle-class and upper-class women rarely do as they often have economic and social buffers to rely on. Thus, women who are poor, First Nations and single parents are most at risk for child apprehension in Canada. Recently, social services have extended their interest from live children to the developing fetus. 3 / 9 WOMEN AND ILLICIT DRUG USE *1 Written by Susan Boyd In Canada, there have been several cases where ministries of social services have apprehended the unborn fetus. On appeal it was ruled that