TIME: Almanac 1993/TIME Almanac 1993.iso/time/051391/0513131.000

Text File | 1992-08-28 | 11.9 KB | 241 lines

                                                                                HEALTH, Page 62

Should We Take Away Their Kids?


Often the best way to save the child is to save the mother as
well

By JAMES WILLWERTH/LOS ANGELES -- With reporting by Mary Cronin
and Christine Gorman/New York


    Try, if you can, to imagine the pain and horror of Daniel
Scott's last hours. The seven-month-old baby was found by police
lying in a pool of blood next to his crib in a Bronx tenement.
His mother, off on a six-day crack binge, had left him in the
care of his father, who abandoned the child in his unlocked
apartment without so much as a bottle of water. Emaciated,
filthy, desperate, the infant had apparently hoisted himself out
of the crib and tumbled onto the wood floor before finally dying
of starvation and dehydration. Both parents -- Jane Scott, 28,
and Jose Valdez, 26 -- have been charged with manslaughter.

    Confronted by such tragic chapters in the saga of crack,
Americans tend to focus on questions of state intervention: At
what point should authorities act to remove a child from the
home of drug-abusing parents? At birth? When there is clear
evidence of abuse or neglect? How about before birth? -- the
position of a growing number of people calling for mandatory
birth control for female addicts. For Daniel Scott, intervention
never came.

    Around the country, prosecutors and state legislators have
lost patience with what they regard as the softhearted and
sometimes softheaded approach of social-service workers.
Nineteen states now have laws that allow child-abuse charges to
be pressed against any woman who gives birth to a child with
illegal drugs in his bloodstream. In some cities local
prosecutors have charged such mothers with a felony: delivering
illegal drugs to a minor. The means of delivery: the umbilical
cord. Floridian Jennifer Johnson, one of the first women
convicted in such a case, was sentenced to mandatory drug
treatment and 15 years of probation.

    In Kansas, state representative Kerry Patrick wants to
take the law a step further. He has introduced a bill that
would require convicted female addicts to accept Norplant
birth-control inserts, which prevent pregnancies for up to five
years, if they wish to avoid jail. Under the proposed law, the
state would pay for the $500 procedure, and also for its removal
if the woman stays clean for a year. Says Patrick: "I've gotten
a lot of support from nurses who deal with crack babies. Once
you see one, you don't care about the rights of the mother."

    Impatience with the niceties of civil liberties is also
found among social-service experts. "Damn it, babies are dying
out there!" says Dr. Michael Durfee, a child psychologist who
tracks child-abuse cases for the Los Angeles County department
of health. "You get someone with a terrible family history,
stoned, no parenting skills -- and we keep giving back her
babies because we don't want to look racist or sexist."

    Testimony from many of the addicts themselves seems to
support Durfee's argument. Doreen Flaherty, 27, a recovering
crack addict from Garden Grove, Calif., remembers spending a
week in jail after being arrested for possession of cocaine. "I
kept crying in jail because I wanted to see my little girl," she
says. "That's all that mattered to me." After she made bail,
Doreen did not return home to her daughter but sought out a drug
dealer instead. When a girlfriend tracked her down at the crack
house, Doreen told the dealer to say she was not there. "How
could you do this to your daughter?" the girlfriend asked. "I'm
sorry, I'm sorry!" Doreen wailed. "I just needed another hit."

    But whisking a baby out of a troubled mother's arms does
not ensure an end to the child's travails. Babies who become
wards of the state have often wound up being boarded in
hospitals for months, tended by ever-changing shifts of nurses.
Such institutional care not only leads to emotional troubles
down the road but can also actually cause "failure to thrive,"
a medical term for a condition in which infants do not gain
enough weight and fail to develop normally. It has been loosely
translated as a loss of interest in life. Older children may be
shuttled through a series of foster homes, never learning to
love or trust a soul. Staying at home with an addicted mother
who is actively participating in a rehabilitation program can,
in many cases, be the more promising and safer route for the
child. "Foster care is often so poor," says Dr. Evelyn Lipper,
director of child development at New York Hospital-Cornell
Medical Center. "Maybe these children are better off with their
mothers."

    Health officials point to another problem with the
get-tough approach. Throwing the book at female addicts for
everything from delivering drugs to a minor to child abuse makes
it even less likely that they will actively seek medical care
when they are pregnant. And scaring them away from the clinic
means even more damaged babies.

    The two U.S. cities with the biggest crack problems have
backed away from their initial seize-the-kids approach. Until
1986, Los Angeles County automatically took at least temporary
custody of drug-exposed newborns. Then the crack epiexploded.
"If we took every child who came out with a positive tox
screen," says Gerhard Moland, a children's services
administrator, "it would overwhelm the system." Now social
workers consider the child's health and the mother's potential
for rehabilitation when making court recommendations. The
biggest factor in determining whether or not the county takes
custody: the presence of a sober grandmother. Currently,
grandmothers care for more than half of the 1,000 high-risk
babies in Moland's district.

    New York City has also shifted strategies. In the
mid-1980s, under the administration of former Mayor Ed Koch, a
single positive toxicology report was enough for authorities to
take a newborn from its mother. But a series of cases of
mistaken charges of child abuse helped lead to a change of
policy under Mayor David Dinkins. In one notorious example,
Brooklyn bank clerk Judith Adams lost custody of her child for
nearly two months after the medication that doctors gave her
during a caesarean section resulted in a false-positive drug
test. "Instead of breast feeding my baby, I was looking for
lawyers and going to social workers' offices, trying to get him
back," she recalls bitterly.

    As in most such mishaps, the victim was a black woman at
a public hospital. The principal reason the Dinkins
administration abandoned the old approach was that it seemed
discriminatory. Minority women giving birth in public hospitals
are much more likely to be tested for drugs than are white women
or patients in private hospitals. But the policy was also
abandoned because it did not work. Explains Susan Demers, deputy
commissioner and general counsel of the New York State
department of social services: "It put the state in the position
of destroying families as the quick-and-easy answer to the drug
epidemic."

    What does seem to work is a combination of the
social-services carrot and the legal stick. The most successful
programs for addicted mothers offer every kind of assistance,
beginning with detoxification but extending to pediatric
services for the child, psychological and job counseling for the
mother, and extensive parenting classes. But all this is backed
up with a none-too-subtle threat of legal intervention. The
Women and Infants Clinic program at Boston City Hospital, for
instance, takes this approach to helping addicted mothers. Women
in the program must submit to random urine tests each week, and
they are told that two unexplained absences in a row will
trigger an immediate investigation for child neglect.

    In many cities, a mother whose newborn tests positive for
cocaine is given a choice: enter a treatment program or give up
the child. This ultimatum can work surprisingly well, provided
that a good program is available. Margaruite Custode was
offered the choice between jail and treatment last June and
picked the latter, figuring that she would dry out, get her baby
back and get high again. Custode, a 30-year-old New Yorker, had
been through detox before, and the treatment never stuck. She
had lost custody of two previous children. But this time she
entered a program at Daytop Village designed for mothers. To her
amazement, she found that within a month she began to connect
with other women in the program and to care about getting clean.
"The fact that we are viewed as unfit mothers by society is one
of the things that bonds us together," she says.

    Drug-treatment experts have found that methods that work
with men often backfire with women. "Women will not be spoken
to harshly or in a condescending manner," says Eugene Williams,
coordinator of a treatment program in East Palo Alto, Calif.
"Nor is it profitable to accuse them of lying or not toeing the
mark as we do in men's programs." Many women addicts turned to
drugs because they were sexually abused or raped as children,
and they need help repairing the damage. Says Custode of her
sessions with other female addicts: "We share some sick secrets
with each other that we wouldn't want to share with the
opposite sex."

    Two things are clear from the case of Margaruite Custode
-- and many others like hers. First, if it were not for the
threat of losing legal custody, she would not have sought
treatment for her drug habit. Second, if it were not for the all
too rare opportunity for first-rate treatment, she would not be
sober for nine months straight with a good chance of regaining
custody of her child. Whether Custode will be a good parent is
impossible to say, but both social-service workers and
law-enforcement officials are finding that the best way to
rescue a child is to rescue the mother as well.


________________________________________________________________
DOWNFALL AND REDEMPTION

    Melinda East, 25, grew up in a less than ideal home
environment. Her siblings smoked crack, and so did her
grandmother. Melinda joined the party at 17. Her father had never
lived at their Los Angeles home, and her mother worked nights as
a nurse. One drug-blitzed evening, Melinda was sexually assaulted
in her own house.

    Her mother's concern only drove Melinda into the streets. "I
was beaten, stabbed and raped out there," she recalls. At 19,
Melinda gave birth to a boy with "the shakes" -- a sign of drug
exposure -- and later deserted him. Arrested for prostitution,
she picked through trash at the police station for food. "That's
when I realized I needed help." After six months of treatment,
Melinda is finally drug free. A second son, born seven months
ago, shakes like his older brother did, but Melinda will get to
keep him. They have a chance for a new life -- if her resolve
holds.

________________________________________________________________
MOTHERS NEED NOT APPLY

    "I started when I was 12 with alcohol and pot," says Janee
Chapman, 26, or Burbank, Calif. "By the time I was 16, it was
cocaine." Pregnant at 17, Janee became a welfare mother. After
her second pregnancy, she discovered crack. "That took me down
real quick," she says.

    Even when social workers took custody of her two children,
Tasha and Sara, Janee did not stop. "I didn't know how to deal
with the pain, except by doing more crack and drinking." When she
became pregnant again, a counselor urged her to search for a
rehabilitation program. None would take an expectant mother. By
the time Janee found Foley House, which treats pregnant women,
she was well into her second trimester. Her son Jesse, now six
months old, has trouble sitting up and rolling over. "The doctors
say the motor skills in his brain just aren't kicking in," she
admits. "They're checking him further. I can't tell you what is
going to happen."