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As you now know, women who use drugs or alcohol during pregnancy can cause serious lifelong harm to their child. Some people have advocated mandatory screenings for women who are pregnant and have a history of drug abuse, and if the women continue using, to arrest, prosecute, and incarcerate them (Figdor&Kaeser, 1998). This policy was tried in Charleston, South Carolina, as recently as 20 years ago. The policy was called the Interagency Policy on Management of Substance Abuse During Pregnancy, and had disastrous results.
The Interagency Policy applied to patients attending the obstetrics clinic at MUSC, which primarily serves patients who are indigent or on Medicaid. It did not apply to private obstetrical patients. The policy required patient education about the harmful effects of substance abuse during pregnancy. . . . [A] statement also warned patients that protection of unborn and newborn children from the harms of illegal drug abuse could involve the Charleston police, the Solicitor of the Ninth Judicial Court, and the Protective Services Division of the Department of Social Services (DSS). (Jos, Marshall,&Perlmutter, 1995, pp. 120–121)
This policy seemed to deter women from seeking prenatal care, deterred them from seeking other social services, and was applied solely to low-income women, resulting in lawsuits. The program was canceled after 5 years, during which 42 women were arrested. A federal agency later determined that the program involved human experimentation without the approval and oversight of an institutional review board (IRB). What were the flaws in the program and how would you correct them? What are the ethical implications of charging pregnant women with child abuse?
The average newborn weighs approximately 7.5 pounds. Although small, a newborn is not completely helpless because his reflexes and sensory capacities help him interact with the environment from the moment of birth. All healthy babies are born with newborn reflexes : inborn automatic responses to particular forms of stimulation. Reflexes help the newborn survive until it is capable of more complex behaviors—these reflexes are crucial to survival. They are present in babies whose brains are developing normally and usually disappear around 4–5 months old. Let’s take a look at some of these newborn reflexes. The rooting reflex is the newborn’s response to anything that touches her cheek: When you stroke a baby’s cheek, she naturally turns her head in that direction and begins to suck. The sucking reflex is the automatic, unlearned, sucking motions that infants do with their mouths. Several other interesting newborn reflexes can be observed. For instance, if you put your finger into a newborn’s hand, you will witness the grasping reflex, in which a baby automatically grasps anything that touches his palms. The Moro reflex is the newborn’s response when she feels like she is falling. The baby spreads her arms, pulls them back in, and then (usually) cries. How do you think these reflexes promote survival in the first months of life?
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