Setting the Record Straight on Motherhood and Drug Use

This is the first in a series of upcoming posts on the topic of pregnancy and drug use.

The vilification of pregnant women who use drugs is nothing new, nor is misinformation and distortion of the facts regarding the impact of drug use during pregnancy. A classic example is the 1980s “crack baby epidemic” in the United States, which later proved to be largely a figment of the media’s imagination. Indeed, as this 2009 New York Times story recounts, scientists who originally posited use of crack cocaine during pregnancy caused significant damage to a fetus went on to retract such claims in the face of clear evidence that other factors, such as malnutrition and lack of pre-natal care, were more significant to fetal and infant health outcomes than illicit drug use.

Nonetheless, the rush to moral judgment and use of scare tactics against pregnant women or mothers struggling with drug addiction has, if anything, intensified in recent years at home and aboard. Russia, in particular, has proven fertile ground lately.  In one instance, seen in the video below, a graphic series of public service announcements produced by the Krasnoyarsk regional government and now circulating widely on the Internet includes a young woman sitting with a series of jars, each containing a fetus with various misshapen limbs and features, which the woman attributes to different drugs she has used in the past.

Another example is the “educational” brochure just issued by a drug treatment center in the city of Tomsk which lists the dire consequences— including still birth, deformities and defects— purportedly faced by pregnant women if they continue to use drugs. It goes as far as to warn that rates of infant death among mothers using drugs is four times that of non-drug users, citing a nearly 70 percent fatality rate for children of heroin users in particular.

In reality, there is no evidence to support such claims within the existing body of scientific literature on pregnancy and drug use, as the group National Advocates for Pregnant Women has documented.  It is, therefore, hard to see any positive benefit to these dangerous misrepresentations in a context where women drug users are already highly marginalized, hidden and fearful.  The sad irony is that the stigma and discrimination faced by drug-using women at the hands of those whose stated aim is to “protect the baby” frequently drives them farther away from services that could lead to better health outcomes for mother and child.

Much more needs to be done to ensure that evidence-based, compassionate and non-judgmental care for pregnant and parenting women who use drugs becomes the norm. Educating medical providers, and engaging them as advocates for their clients, is critical.  In November, with support from Open Society Foundations, a diverse group of doctors, policy makers, and community service providers from Asia, Central and Eastern Europe, Central Asia and the Caucasus, and Canada convened for a week-long seminar on pregnancy, HIV and drug use in Salzburg, Austria. Participants had the opportunity to learn about international best practices in treatment and care for pregnant women drug users­— including the Fir Square Rooming-in Program and Sheway in Vancouver, British Columbia, those work was profiled by local media in 2008— as well as share the results of initial work being done in countries like Russia, Kyrgyzstan and Ukraine to improve the access of women drug users to sexual and reproductive health care services and prenatal care.

In addition, we need to do more to highlight the experience of women like Tanya, a young mother from Ukraine who is HIV positive and has a history of drug use, as told in a recent documentary supported by the Open Society Foundations seen below.  Her story provides a powerful counterpoint to the dehumanizing and sensationalistic media accounts which perpetuate the myth that drug use and motherhood are incompatible.

For more on the work in Ukraine, see Open Society Foundations publication Making Harm Reduction Work for Women, the Ukraine Experience.

Update November 15, 2011: The video clip of the series of public service announcements has been removed from this post as it is no longer publicly available on YouTube.

12 Comments

Apart from sound medical advice,physilogicals aids which may be profound like keeping a holy book,silence,reading the holy scriptures,or something the mother feels positive about may be also be of help atleast there will be no adverse impact.Medical aid must not be denied in such cases where it is in fact more needed remember there are at least two beings mother and child.

Are you kidding me? This article seems to suggest that we should sympathize with a mother-to-be who is "battling drug addiction." When are we, as citizens, going to start taking responsibility for our own actions?

this is for rachel & anyone else who demonizes us-- my girl mya was born under crazy & difficult circumstances and anyone who knows her knows that had policy been more matter of fact & less judgment & let's put mom in a box for the good of the baby, these people had all this paranoia AND NO UNDERSTANDING OF THE COMPLICATED SITUATION WE WERE IN...all I knew was when I was completely abstinent from all "mothers little helper's", my baby quit moving like she had been, and SOMETHING did not feel right, like it had when i made the radical decision to have her at all, no matter what! This kid has been the most charming, clever, beautiful & magnetic and she will be 11 this year.

There is a lot of toxicologic research showing that some drugs taken by a mother during pregnancy can interfere with normal fetal development. Phenytoin, for instance, is known to be associated with cleft palates. The point is not to stigmatize a drug-taking mother but to inform her that use of substances that affect her brain will cross her placenta and affect the brain of her fetus and, possibly, its formation. Pregnant women need to seek the counsel of competent physicians, knowledgeable in psycho-pharmacology and the risks associated with these substances when taken during pregnancy. The fact that there are some claims not validated by subsequent research does not justify the erroneous inference that there is little toxicological research supporting the admonition that pregnant mothers avoid taking psychoactive substances during pregnancy, if medically possible.

Anyone who has known even a few women during their pregnancy and the children afterwords can tell you that even the emotional state of the mother during pregnancy effects the mental health of the child.
So it is recklessly foolish to even toy with the idea that drugs don't effect a child.
Babies aren't experiments!

I think some of you are missing the point here. The article doesn't suggest women should continue to take drugs during pregnancy- it is saying that the stigma for pregnant drug users is increased by reports that exaggerate the harm done to the unborn child. This stigma makes it more difficult for the woman to seek help with her addiction.

No one is saying people shouldn't take responsibility for their actions- an even if you have no sympathy for the mother I would hope you have some for the child. And that you can see the best possible thing for that child is for the mother to get treatment. And then see that making it easier to access that treatment will make it more likely the mother, and through her the baby will get that help.

I have been using drugs for the past 45+ years. The worst of the worst was booze, I did things that I was ashamed of and things that were against my moral code. I have not had a drink in 28 years, although through my life I spent millions of dollars. My family never went with out. I was successful in many small business traveled the world, experienced ever pleasure known to man and never stole or hit a old lady on the head with a brick for money.I still get high on hard drugs occasionally I want to work for your organisation.

I believe the main objective of the artical is to reduce harm related with drug use on pregnant women if they could not quit drugs immidiately or not ready to go to rehab at this point. It is true that reproductive health very important to every woman including woman who use drugs. Health of mother and a baby should not be ignored based on the judgement made on drug use and morality. If the pregnant women drug user would be able to access those medical services, there are lots of consequences we can prevent for both mother and the child before, during and after the labour and delivery.

Unfortunately, stigma and discrimination by society and health care providers causes the drug using women can not have access to the health services, no matter if they are in developed or underdeveloped countries.

TANZANIAN YOUTH COMMUNITIES ARE AMONG THE PEOPLE AFFECTED COMPLETELY WITH DRUG ABUSE. I KNOW THE EFFORTS MADE BY OPEN SOCIETY FOUNDATION IN TO PROTECT THEM AGAINST THESE CALAMITY. NOW IS RIPE TIME FOR OSF TO TURN BACK AND SUPPORTING LOCAL INITIATIVES WHICH ALREADY TAKEN BY LOCAL ORGANIZATIONS LIKE TYAECA IN TANZANIA. ARE YOU READY TO DO SO?

The article does not set the record straight. On the contrary, it is misleading, based on half-truths and hence, dangerous.

There are MILLIONS of children born to addicted mothers. Take a look at what is happening to Afganistan and Iran. We are talking about generations here not the odd drug addict.

It HAS been proven that heroin use during pregnancy affects the fetus in more ways than one.

Last but not least, don't be fooled. It is not the stigma that makes addicted "mothers" deny help. It's the addiction itself.

I personally know a case of a "mother", hard core junky of 14 years and counting who used and abused heroin, cigarettes, weed and pills during her pregnancy. She declined the help provided by the social services because she doesn't want to quit. She didn't care that her child went through withdrawal right after it was born. She doesn't care that she has no money, no job, no home. She only cares about her next fix. That is what addiction does to people.

Ms Tolson, I suggest you are more carefull with the subject.

@genaveve

Your response does not make sense.

You didn't mention if you are clean, how many years and if your child has had trouble.

Actions yield consequences and there is no doubt why drug addiction is followed by social stigma.

True, your situation must have been or still is very complicated, but you are not taking responsibility of your actions by saying that others demonize you. You are demonizing yourself.

I am very sorry that your daughter was born to a drug addict. I hope she doesn't follow your steps.

Enough with this empathy. Drug addicts should not have children. Children are not experiments.

What happend to the video above? What was it about? Can I find it anywhere else? Best, Nanna, Copenhagen

Add your voice