Michele Bratcher Goodwin,
"Reproductive Carrots and Sticks"
(page 8 of 9)
Part IV: Reproductive Policing—A War On Drugs 2.0
Scholars have argued that reproductive policing originated in the
"Reagan-Bush war on drugs and the unprecedented media coverage of the
'crack crisis,'" which coincided with resurgence in the anti-abortion
movement.[64]
Lynn Paltrow argues that "[p]regnant women became an
appealing target for law enforcement officials who were losing the war
on drugs and for the anti-choice forces whose goal has been to develop
'fetal rights' superior to and in conflict with the rights of
women."[65]
In fleshing out this idea further, Paltrow suggests
"[p]regnant, drug-using women, portrayed as depraved, inner-city African
American women who voluntarily ingested crack to poison their children,
were not likely" to engender public sympathy.[66]
In fact, a six-month
study of five public health clinics and twelve private obstetrical
offices in Pinellas County, Florida found that 14.1% of black pregnant
women tested positive for drug and alcohol use, compared to 15.4% of
white women.[67]
The most revealing aspect of the study was that only
1.1% of the pregnant white women testing positive for drug use were
reported to health authorities as compared to 10.7% of black
women.[68]
Among the conclusions that can be drawn from the study, that pregnant
black women were a convenient scapegoat for two fervent movements, the
war on drugs and the anti-abortion campaign, is one.
However, the analysis that anti-drug and anti-abortion campaigns were the
sole cause of womb policing is insightful, but incomplete. The rise of
the war on drugs and anti-abortion movements may have combined to bring
about a particular attention to black women's reproduction, but the
realities are that womb policing existed prior to the Reagan-Bush
administration of the 1980s. Both the eugenic movements at the turn of
the 20th century and subsequent sterilization laws enacted during the
period of 1950-1970, indicate that reproductive policing pre-existed
Reagan era war on drugs policies. However, the persistence of
reproductive policing has yet to succumb to more enlightened thinking.
Why is that? In part, the answer can be found in a deeply
embedded perception of reproduction hierarchies in the United States,
and these reproductive hierarchies span across liberal and conservative
spaces. In other words, reproductive policing is not exclusively a
conservative movement.
Part V: A Few Normative Conclusions
Enacting legislative policies that help women craft healthy prenatal
choices is an urgent carrot goal of which I am in favor. To be
sure, prosecuting pregnant women of any socio-economic background for
drug use (legal or illegal) during pregnancy, with the specific aim to
win convictions more severe than drug distributors and to shame and
spectacle them, will not achieve economic efficiency, rehabilitate
mothers, promote healthy families, restore economic viability of
households, nor enhance the educational, economic, and social
development of children. If resources are finite, then financial
resources directed at policing and prosecuting pregnant women will
divert funds from rehabilitation programs. In other words, legislatures
will invest in policing and punishment, but not rehabilitating and
counseling drug-dependent women. Because of this, we can predict a few
problems.
Calibrating the appropriate focus of FDL enforcement may be difficult
for police and prosecutors, and enforcement of FDLs may be different
throughout a state. For example, some jurisdictions may focus
primarily on punishing pregnant crack users. But such an approach could
result in the under-monitoring of other illicit drug use that
poses risks of harm to fetuses and children. If resources are finite,
directing public funds at policing, prosecuting, and incarcerating crack
addicts diverts funds from monitoring actual child abuse cases, and
creates a gap in the monitoring of smoking, alcohol misuse,
methamphetamine abuse, and overuse of prescription medications during
pregnancies. If this is true, nurses and doctors might be overly
attentive to pregnant women that have used crack, but for the wrong
reasons.
First, rather than focusing on carrots: treatment, education,
and support for pregnant crack addicts, medical personnel might be more
concerned about competently carrying out their new roles as police
informants and evidence collectors. Second, focusing almost exclusively
on the use of crack in pregnancy might draw a false bright line of fetal
harm. The tacit assumption will be that crack use deserves more serious
monitoring than overuse of prescription medications during pregnancy or
alcohol and smoking. Of course, it could be the case that wealthy women
who engaged in other types of risky behaviors during pregnancy receive
effective rehabilitative care.
Overfunding crack-tracking and underfunding the monitoring of illicit
drug use among pregnant women will likely disserve the state's ultimate
goal—or at least expose the fault lines in the policies on which the
laws are predicated. In other words, if one is to believe that the best
approach to protecting fetal health is to monitor and police drug use,
then overfunding the investigation of crack use detracts from other
types of drug abuse. More importantly, incarcerating pregnant drug
users does not "help" their fetuses. Jailing this cohort will not help
the state to deter other women from smoking, drinking alcohol, or
abusing prescription medications during their pregnancies.
By decoupling our concern for the health of fetuses from crack
prosecutions, states might better address the broader issue of
maternal/fetal health, including developing frameworks to respond to
assisted reproduction pregnancies. Such frameworks might involve
investigating physician conduct for aggressive, in-person advertizing of
fertility services that suggest implausible "success" rates. Or, states
could pay greater attention to transition or hybrid-like services that
involve an element of state enforcement, such as mandated
rehabilitation. Such rehabilitation could take place in group home type
environments, thereby permitting babies to be onsite, rather than in
foster care. The point here is that current practices obviate the need
for more humane, efficient, and consistent practices across groups of
women who engage in risky behavior during pregnancies.
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