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NAPW Analysis of Washington D.C.'s:
"Improved Child Abuse Investigations Amendment Act of 2001"
Protection Act of 2001"
In the Fall of 2001, the Washington D. C. City Council proposed two bills the Improved Child Abuse Investigations
Amendment Act of 2001 and the Infant Protection Act of 2001. These bills both appear to be a response to a Washinton
Post series that soundly critizesd D.C.’s child welfare system on numerous ground, including its failure to track
and protect children placed into its foster care system. ( ) Rather than address the
numerous failings, DC counsel members proposed two bills that would treat any evidence of prenatal exposure to an
illegal drug as evidence of civil child neglect. Based on research, science, and experience it is clear that these
bills will not protect children, but instead will unnecessarily entangle families—particularly families of
color– in a system that is poorly prepared to judge or handle issues involving claims of drug use. Below we
address some of the key myths and issues associated with the proposed legislation.
MYTH # 1: A WOMAN WHO USED DRUGS WHILE PREGNANT WOULD BE UNABLE TO CARE FOR HER CHILD ONCE BORN.
The primary purpose of the child welfare laws is to protect children from harm. In order to do that the question
that must be asked is whether a parent is capable of parenting - not whether an unconfirmed drug test indicates that a
parent has once smoked marijuana or used any variety of drug, legal or illegal.
Research fails to support the assumption that a parent who uses any amount of any illegal drug will harm his or her
children or will be unable to provide them with a loving home. A single, positive drug test cannot determine whether a
person occasionally uses a drug, is addicted, or suffers any physical or emotional disability from that addiction.
Indeed, there are many reasons why a person might be unable to parent, including mental illness, failure to take
medication for chronic illnesses such as diabetes, and use of alcohol. But, we would never report someone as a
suspected child abuser or presume his or her parental unfitness based only on the knowledge that a person has had a
mental illness, or is a diabetic, or drinks alcohol.
Most importantly, a single drug test simply is not predictive of a person's parenting ability. As Susan C.
Boyd, in her recent book Mothers and Illicit Drugs: Transcending the Myths, found, there is no significant difference
in childrearing practices between addicted and non-addicted mothers. This includes mothers who use cocaine who have
been found to look after and care for their children adequately. ( ) As a report published
by the American Bar Association concluded: [M]any people in our society suffer from drug or alcohol dependence
yet remain fit to care for a child. An alcohol or drug dependent parent becomes unfit only if the dependency results in
mistreatment of the child, or in a failure to provide the ordinary care required for all
children." ( )
Finally, the fact that the particular drug used or behavior indicated is illegal is not the relevant question for
child welfare purposes. Child welfare experts agree that the purpose of civil child welfare laws is to protect children
from future harm and not to punish parents for past wrongdoing.
MYTH # 2: ALL DRUG-EXPOSED CHILDREN ARE SERIOUSLY DAMAGED AT BIRTH.
Some newborns exposed prenatally to some substances do suffer adverse short or long-term consequences. These infants
include those whose mothers lacked access to quality prenatal care and adequate nutrition, smoked or drank while
pregnant, or used fertility-enhancing medications that cause multiple births associated with prematurity and other
life-threatening hazards. ( ) However, sensational, inaccurate, and misleading news reports,
especially about crack/cocaine, have convinced many people of the necessity for punitive responses to the problem of
drug-exposed children. Even the recent series in the Washington Post perpetuated these myths. For example, one story
reported that a baby "suffered withdrawal from the cocaine her mother had used" ( ) even
though medically this does not occur. ( ) Today, dozens of carefully constructed studies
establish that the impact of cocaine on newborns has been greatly exaggerated and that other factors are responsible
for many of the ills previously associated with cocaine use -- with poverty chief among them.
To expand on one example, women who take fertility-enhancing drugs and refuse to reduce their multiple pregnancies
place all of their fetuses at grave risk. In many instances of super multiples, one or more of the fetuses/newborns
die; all generally require extensive time in the neonatal intensive care unit and many experience lifelong disabilities
as a result of premature birth. The substantial likelihood of multiple pregnancies that place at grave risk both mother
and babies is thoroughly documented in the professional literature. Despite this, women who use fertility drugs and
have multiple pregnancies are generally lauded in the press and rewarded by the public. If one rationale of the
proposed bill is that a woman who harms her fetus during pregnancy deserves to have her parenting ability questioned,
fairness and logic would require that women who use fertility drugs, work in jobs that expose them to hazardous
chemicals, or who are unable to obtain an adequate diet or prenatal care also be subjected to mandatory reporting,
investigation, and a presumption of parental unfitness.
MYTH # 3: WOMEN WHO USE DRUGS COULD SIMPLY STOP, AND FAILURE TO DO SO INDICATES DISREGARD FOR THE FUTURE
Some women who use drugs during pregnancy are not addicted and may, like some people who drink alcohol or smoke
cigarettes, use drugs only on an occasional basis. Other women, however, may be addicted. As the United States Supreme
Court ( ) and the health community ( ) however have long
recognized, drug addiction is an illness that benefits from appropriate treatment, not punishment. The American Medical
Association has unequivocally stated, "it is clear that addiction is not simply the product of a failure of individual
willpower. Instead, dependency is the product of complex hereditary and environmental factors. It is properly viewed as
a disease, and one that physicians can help many individuals control and overcome." ( ) As
the California Medical Association concludes:
Prenatal substance abuse by an addicted mother does not reflect willful maltreatment of a fetus, nor is it
necessarily evidence that the mother will abuse her child after birth. A woman with a substance abuse problem may
genuinely desire to terminate the use of such substances prenatally but may be unable, without access to substance
abuse treatment programs, to act on her desire. ( )
Unfortunately, few women have access to such programs. Despite the proven efficacy of treatment
programs, ( ) and notable attempts to improve access to treatment, there is a severe lack of
adequate treatment for everyone, but especially for women. ( ) Research demonstrates that
comprehensive treatment programs that do not separate mothers from their children help women and their
families. ( ) They are also cost-effective, especially when one compares their price tag to
the staggering financial and social costs of separating mother and child. ( )
MYTH # 4: TREATING A PREGNANT WOMAN’S DRUG USE AS ABUSE AND REQUIRING CHILD WELFARE INTERVENTION WILL PROTECT
CHILDREN AND IMPROVE THEIR HEALTH.
In the 1980s, New York, as a matter of policy, began reporting and investigating all cases where children where
exposed prenatally to an illegal drug. A lawsuit was filed on behalf of dozens of families who had newborns removed
based on false positives and innocent positives (positive results for drugs prescribed or administered by a health care
provider). ( ) As a result of the policy, hospital nurseries were filled with healthy
infants and an already overburdened child protective system was overwhelmed with unnecessary
referrals. ( ) Eventually this costly and counterproductive policy was stopped as a result
of a consent decree reached in response to the lawsuit.
Studies have also found that removing children from their parents’ care can unnecessarily inflict grave harm
on the children. ( ) As a result of newly expanded civil neglect laws in some states,
"thousands of women have lost custody of their children." ( ) One comprehensive survey of
the effects of foster care concluded that "[r]emoving a child from his family may cause serious psychological
damage—damage more serious than the harm intervention is supposed to prevent." ( )
Research has also shown that Òthe increasing placement of drug-exposed children in foster care is coupled with
poor growth outcomes in the physical, mental and emotional development of these
children.Ó ( )
Furthermore, the proposed bills may in fact lead to more "child" endangerment. As studies of prenatal care and
of drug using pregnant women have found, fear of losing custody of a child deters women from seeking the prenatal
health care and drug treatment that can improve both their heath and that of their children. Research by the Southern
Regional Infant Mortality Project on barriers to substance abuse treatment for pregnant women found that Òfear
of losing their childrenÓ was the greatest deterrent to women. ( ) In fact, South
Carolina’s infant mortality rate increased for the first time after a decade of steady decline, following the
statewide implementation of laws that treat a pregnant woman’s drug use as presumptive civil neglect as well as a
crime. ( )
Finally, child welfare workers have woefully inadequate training regarding issues of drug and alcohol
abuse. ( ) Indeed, experience around the country indicates that often the decisions they
make are not in the best interests of the child. A few examples that are neither exceptional nor unusual include:
California child welfare workers removed children from a mother’s custody based on a positive drug test that
was actually a drug given to the pregnant woman during labor. ( ) Workers in Texas and New
York removed children from a mother’s custody and put them in costly foster care based on a single positive drug
test for marijuana despite the lack of any evidence of harm whatsoever or any indication of neglect or
abuse. ( ) In New Jersey, child welfare workers mistakenly view methadone treatment as drug
addiction and threatened to remove a child if a woman did not enter a program they selected that would require her to
stop her successful methadone treatment. ( )
MYTH # 5: A STATUTE TREATING A SINGLE DRUG TEST AS PRESUMPTIVE EVIDENCE OF CHILD ABUSE CAN BE ADMINISTERED
These laws, if enacted, are likely to be applied in a highly racially discriminatory fashion. In Florida,
researchers studied reporting practices under statutes similar to those under consideration here. Researchers found
that while white and African-American women used illegal drugs at approximately the same rate (white women slightly
higher) African-American women were 10 times more likely to be reported as child
abusers. ( ) Similar results were found in Illinois. ( ) This is
one reason why African American women and their children are already greatly over represented in child welfare systems
across the nation:
In January 1999, Black children made up forty-five percent of the foster care population although they were
only fifteen percent of the general population under age eighteen. The disparity is even more alarming in the
nation's big cities. Removal of children because of maternal substance abuse has contributed significantly to
the increase in numbers of poor Black children pouring into foster care. ( )
Indeed, because these bills do not mandate universal drug testing – of every pregnant woman and newborn,
discriminatory application of the laws is all but guaranteed. And while such a provision would be necessary to ensure
some measure of fairness, it would be extremely expensive. A 1994 cost estimate in New York concluded that it would
cost New York state 26.1 million dollars a year to perform Urine Drug Screens alone and an estimated 95.9 million to
include alcohol and confirmatory drug tests. ( ) This money could much more wisely be spent
on training mandated reporters and health workers to evaluate effectively true markers of neglect and to establish the
comprehensive treatment programs that women and families need and what.
MYTH # 6: SUBJECTING A NEW MOTHER TO A CHILD WELFARE INVESTIGATION REPRESENTS ONLY A MINOR INTRUSION.
Parents and child welfare advocates alike understand that some intrusions on parental rights and family privacy are
sometimes necessary to protect children. Nevertheless, it is a grave mistake to assume that a child welfare
investigation is a minor intrusion. Indeed, this story will help illuminate the kinds of experiences real families
Family friends of ours live in an apartment building next to a neighbor who is hypersensitive to noise. This
neighbor had long been unhappy living next door to a family with three children. Her complaints about noise included a
threat to call child welfare if this family did not maintain the level of quiet that she demanded. In fact, the family
believes that it was this neighbor who eventually made an anonymous call to child welfare alleging that the children
were being abused and that one of the parents used drugs.
The parents received a visit from child welfare in the middle of the night. They promptly let in the workers who
were allowed to see three healthy children fast asleep in their beds. Nevertheless, because a complaint had been made,
they were told that they would both have to report to child welfare office downtown. Both parents took off from work
and dutifully reported to the downtown office. Instead of being interviewed as they had expected, they were told that
they must provide urine samples for drug screening. No court order was provided, not even an explanation, only the
veiled threat that their children might be taken away if they objected. They were then escorted back up town to a
dismal testing lab where they were told to wait, fill out consent forms (that required in essence a confession: "I
consent to disclosure of all information about the treatment of my condition"), and that they would have to provide a
urine sample. Both complied and provided a urine sample. They then also obtained urine screens at their own expense
from an independent lab out of concern for quality of testing. They were then required to have two more home visits
from child welfare workers who interviewed each family member. Each of these visits required rescheduling work and a
complex schedule of after school activities for the children. Although there was never any doubt that these were model
parents, the whole family was anxious, worried, and sometimes even depressed at the possibility, no matter how small,
that a hostile case worker or bureaucratic mistake might result in removal of their children. Child welfare also
required the parents to produce medical records and school attendance records for each child. Both of these demands
required the parents to take time from work to gather the paper work from two different schools and the pediatrician.
It also required them to have to reveal this embarrassing and upsetting investigation to a variety of people who
obtained the records needed.
Even though their urine drug screens were negative, they were told, again without any official order or document,
that they had to submit to a second urine drug screen at a time and place required by child welfare. Both parents again
missed a half a day of work. Finally, after more than a month of investigation they received an official notice from
the state that the complaint was unfounded. Nevertheless, the child welfare worker insisted that she must make another
home visit before the case could be formally closed in her office.
This event was very traumatic for the whole family. Adopting a bill that will predictably require investigation of
hundreds if not thousands of families who in fact have not ever abused much less neglected their children is an extreme
waste of resources and disregard for regard for family well-being.
WHAT SHOULD BE DONE?
The purpose of civil child welfare laws is to protect children from future harm: not to punish parents for past
wrongdoing. Accordingly, the Center for the Future of Children recommends that "[a]n identified drug-exposed
infant should be reported to child protective services only if factors in addition to prenatal drug exposure show that
the infant is at risk for abuse or neglect." ( ) Rather than implement either of the
proposed bills, the Council should instead adopt measures that will increase access to appropriate, confidential drug
treatment and other health services for pregnant and parenting women. The Council should improve the ability of child
welfare workers and mandated reporters to identify and respond to real evidence of abuse or neglect rather than to use
any single marker as a substitute for such an evaluation. Many positive alternatives exist to the proposed bills. Among
- Ensure that drug treatment, prenatal care, and other reproductive and mental health services are widely
available and fully accessible to pregnant and parenting women.
- Create and fund treatment programs that follow the recommendations of experts on women’s
treatment. ( )
- Provide meaningful training to child welfare workers on issues of drug and alcohol use and treatment for drug
addiction as well as issues of post traumatic stress disorder that are highly associated with drug and alcohol
problems. ( )
- Sponsor research to determine the efficacy of similar statutes in other states. Significantly, it appears
that no state that has defined drug use during pregnancy as civil child neglect has engaged in any systematic study to
determine the cost, effects or results of the laws.
- South Carolina’s dramatic increase in infant mortality rates since implementation of such laws is one
strong indication of the need for such investigation.
- Enforce anti-discrimination laws against existing programs that deny access to pregnant women. Increase
training for child welfare workers and reduce their caseloads so that they can identify and respond appropriately to
all cases where a parent’s behavior in fact indicates an inability to parent.
- See http://www.washingtonpost.com/wp-dyn/metro/dc/government/lostchildren/.
- Susan C. Boyd, Mothers and Illicit Drugs: Transcending the Myths 14-16 (1999) (listing at least
fourteen studies demonstrating that women who use illicit drugs can be adequate parents); see also M. Kearney et al.,
Mothering on Crack Cocaine: A Grounded Theory Analysis, 38 Soc. Sci. & Med. 351, 355 (1994).
- American Bar Association, Foster Care Project, National Legal Resource Center for Child Advocacy and
Protection, Foster Children in the Courts 206 (Mark Hardin ed., 1983) TA \l ÒAmerican Bar Association, Foster
Care Project, National Resource Center for Child Advocacy and Protection, Foster Children in the Courts (M. Hardin ed.
1983)Ó \s ÒAmerican Bar Association, Foster Care Project, National Resource Center for Child Advocacy and
Protection, Foster Children in the Courts 206 (M. Hardin ed. 1983)Ó \c 3 . See also Nat’l Council of
Juvenile and Family Court Judges, Permanency Planning for Children Project, Protocol for Making Reasonable Efforts to
Preserve Families in Drug Related Dependency Cases 17 (1992) (concluding that "Juvenile and family court proceedings
are not necessary, and probably not desirable, in most situations involving substance-exposed infants").
- For example, the Committee to Study the Prevention of Low Birthweight found numerous behaviors and
risk factors besides the use of illegal substances that increase the chances of bearing a low birthweight infant,
considered to be the greatest single determinant of infant mortality in the United States. Committee to Study the
Prevention of Low Birthweight, Division of Health Promotion and Disease Prevention, Institute of Medicine, Preventing
Low Birthweight - Summary 1 (1986) at 1-7. Among the behavioral and environmental factors that contribute to low birth
weight are smoking cigarettes, poor nutritional status, exposure to occupational hazards and living at a high
- Sari Harris & Scott Higham, Without Help, Frail Infants Dies, Washington Post (Sept 11, 2001
- See Barry Zuckerman, MD, Drug Exposed Infants: Understanding the Medical Risk 26, 31 in Center for
the Future of Children, 1 The Future of Children (Spring 1991) ("A withdrawal syndrome has not been identified and,
therefore, at this time it is inaccurate to describe a cocaine-exposed newborn as crack-addicted.").
- Research has found that crack-exposed children are not doomed to suffer permanent mental or physical
impairment, and that whatever effects may result from the use of this drug are greatly overshadowed by poverty and its
many concomitants – poorer nutrition, inadequate housing, health care and stimulation once the child is born. See
Deborah A. Frank, MD et. al., Growth, Development, and Behavior in Early Childhood Following Prenatal Cocaine Exposure:
A Systematic Review, 285 JAMA 1613 (Mar. 28, 2001); Wendy Chavkin, MD, MPH, Cocaine and Pregnancy – Time to Look
at the Evidence, 285 JAMA 1626 (Mar. 28, 2001); Hallam Hurt, M.D. et al., Problem-Solving Ability of Inner-City
Children With and Without In Utero Cocaine Exposure, 20 Dev. & Beh. Pediatrics 418 (Dec. 1999); Alan Mozes, Poverty
Has Greater Impact Than Cocaine on Young Brain, Reuters Health, Dec. 6, 1999. See also Linda C. Mayes et al., The
Problem of Prenatal Cocaine Exposure: A Rush to Judgment, 267 JAMA 406 (1992). As yet other researchers explain:
The "crack baby" on which drug policy is increasingly based does not exist. Crack babies are like Max Headroom and
reincarnations of Elvis – a media creation. Cocaine does not produce physical dependence, and babies exposed to
it prenatally do not exhibit symptoms of drug withdrawal. Other symptoms of drug dependence – such as "craving"
and "compulsion"—cannot be detected in babies. In fact, without knowing that cocaine was used by their mothers,
clinicians could not distinguish so-called crack-addicted babies from babies born to comparable mothers who had never
used cocaine or crack.
John P. Morgan & Lynn Zimmer, The Social Pharmacology of Smokeable Cocaine Not All It’s Cracked Up to Be, in
Crack in America: Demon Drugs and Social Justice 131, 152 (Craig Reinarman & Harry G. Levine eds.,
- See Linder v. United States, 268 U.S. 5, 18 (1925) ("[Addicted persons] are diseased and proper
subjects for [medical] treatment."); cf. Robinson v. California, 370 U.S. 660, 666-67 (1962) (holding unconstitutional
a state law making narcotic addiction a crime).
- American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders 176 (4th ed.
1994) ("The essential feature of substance dependence is a cluster of cognitive, behavioral, and physiological symptoms
indicating that the individual continues use of the substance despite significant substance related problems. There is
a pattern of repeated self-administration that usually results in tolerance, withdrawal, and compulsive drug-taking
- American Medical Association, Proceedings of the House of Delegates: 137th Annual Meeting, Board of
Trustees Report NNN: Drug Abuse in the United States: A Policy Report 236, 241 (1988).
- Amicus Curiae Brief of California Medical Association & American College of Obstetricians and
Gynecologists, District 9, at 3-4, In Re Adrianna May H., No. 3 Civil CO14203 (Cal. Ct. App. 3d filed June 17,
- ADVANCE \r5 See Charles Marwick, Physician Leadership on National Drug Policy Finds Addiction
Treatment Works, 279 JAMA 1149 (1998). TA \l ÒCharles Marwick, Physician Leadership on National Drug Policy
Finds Addiction Treatment Works, 279 JAMA 1149 (1998)Ó \s ÒCharles Marwick, Physician Leadership on
National Drug Policy Finds Addiction Treatment Works, 279 JAMA 1149 (1998)Ó \c 3 The Physician Leadership on
National Drug Policy reviewed more than 600 peer-reviewed research articles and found that addiction to illicit drugs
can be treated with as much success as other chronic illnesses like diabetes, asthma, and hypertension.
- See, e.g., Wendy Chavkin, Mandatory Treatment for Drug Use During Pregnancy, 266 JAMA 1556 (1991);
Julie Petrow, Addicted Mothers, Drug Exposed Babies: The Unprecedented Prosecution of Mothers Under Drug-Trafficking
Statutes, 36 N.Y.L. Sch. L. Rev. 573, 604-06 (1991) (arguing for an increase in federal and state funding for drug
treatment programs for women); Molly McNulty, Note, Pregnancy Police: The Health Policy and Legal Implications of
Punishing Pregnant Women for Harm to Their Fetuses, 16 N.Y.U. Rev. L. & Soc. Change 277, 292-303 (1987) (discussing
the lack of access to adequate health care); Wendy Chavkin et al., National Survey of the States: Policies and
Practices Regarding Drug-Using Pregnant Women, 88 Am. J. Pub. Health 117 (1998); Legal Action Center, Steps to Success:
Helping Women with Alcohol and Drug Problems Move From Welfare to Work 3 (May 1999); see also Drug Strategies, Keeping
Score, Women and Drugs: Looking at the Federal Drug Control Budget 16-17(1998); Vicki Breitbart et al., The
Accessibility of Drug Treatment for Pregnant Women: A Survey of Programs in Five Cities, 84 Am. J. Pub. Health 1658
(1994); see also Elaine W. v. Joint Diseases N. Gen. Hosp., Inc., 613 N.E.2d 523, 524 (N.Y. 1993) (discussing a New
York hospital’s refusal to admit pregnant women into its drug detoxification program).
- See, e.g., Stephen Magura et al., Effectiveness of Comprehensive Services for Crack-Dependent
Mothers with Newborns and Young Children (1998) (discussing New York City’s experience with the Family
Rehabilitation Program and citing numerous studies describing how comprehensive, coordinated, holistic treatment is
better at engaging pregnant and parenting women); Pregnant, Substance-Using Women, supra note 97; Claire McMurtrie et
al., A Unique Drug Treatment Program for Pregnant and Postpartum Substance-Using Women in New York City: Results of a
Pilot Project, 1990-1995, 25 Am. J. Drug & Alcohol Abuse 701, 701-02 (1999) (describing a comprehensive model of
drug treatment for pregnant and postpartum women that included children and did not view relapse as a failure,
concluding that it "seem[ed] to improve mother’s lives, fetal drug exposure, and birth outcome significantly");
see also Practical Approaches, supra note 99 at 68, 97-98.
- See Marwick, supra note 11 at 1149 (discussing the fact that drug "treatment costs ranged from
$1,800 per patient for outpatient treatment to $6,800 for long-term residential care," which is far less expensive than
the $25,900 per year it costs to keep one person in prison); see also The Future of Children, supra note 5, at 14
(noting that "it is extraordinarily costly for government to rear children through foster care, with costs typically
around $3,000 per year per child, but reaching as high as $35,000 or even double that when the children have special
medical complications"). TA \l ÒCenter for the Future of Children, Recommendations in The Future of Children
(Richard F. Behrman ed., 1991)Ó \s ÒCenter for the Future of Children, Recommendations in The Future of
Children 13 (Richard F. Behrman ed., 1991)Ó \c 3
- Jan Hoffman, Challenge Drug Tests, The Village Voice, July 10, 1990, at 11; see also Class Action
Complaint, Ana R. v. New York City Dep't of Social Services (S.D.N.Y. filed on June 7, 1990) (describing numerous cases
of children removed without notice based on false positives or positive test results for drugs administered by
physicians during labor).
- See Laura Lassor, When Success Is Not Enough: The Family Rehabilitation Program and the Politics of
Family Preservation 7 (unpublished manuscript on file with NAPW) (describing how "a backlog in investigations and
foster care placements caused hundreds of infants to be held in New York City hospitals for as long as several months
after they were medically ready for discharge"); Diane Duston, Boarder Babies Straining Hospitals’ Resources,
Associated Press, June 23, 1992 (quoting David Liederman, executive director of the Child Welfare League, who asserts
that the government should help families in distress solve their problems, instead of focusing on punishment for drug
use); see also Denise Paone & Julie Alpern, Pregnancy Policing: Policy of Harm, 9 Int. J. Drug Policy 101, 104
(1998) (noting that as a result of being kept in hospitals for extended periods of time "these children may be
condemned to living conditions that pose greater harm to their well-being than the ones from which they were
removed");. See also Wendy Chavkin, Drug Addiction and Pregnancy: Policy Crossroads, 80 Am. J. Pub. Health 483
- See, e.g., Bonita Evans, Youth in Foster Care: The Shortcomings of Child Protection Services (1997);
Scott J. Preston, Note, "Can You Hear Me?": The United States Court of Appeals for the Third Circuit Addresses the
Systemic Deficiencies of the Philadelphia Child Welfare System in Baby Neal v. Casey, 29 Creighton L. Rev. 1653 (1996).
See also Dorothy E. Roberts, Access to Justice: Poverty, Race and New Directions in Child Welfare Policy, 1 Wash. U.
J.L. & Pol’y 63, 69, 71 (noting that "[c]hildren, even neglected children, typically value and want to
maintain a relationship with their parents." And that "[u]necessarily taking children from their families is comparably
harmful to children as returning them to dangerous homes.").
- Paone & Alpern, supra note 16 at 101.
- Michael Wald, State Intervention on Behalf of Neglected Children: A Search for Realistic Standards,
27 Stanford L. Rev. 985 (1975).
- Michelle Jackson & Gordon Berry, Motherhood and Drug Dependency: The Attributes of Full-time
Versus Part-time Responsibility for Child Care, 29 Int’l J. Addictions 1521 (1994). See, e.g., Bonita Evans,
Youth in Foster Care: The Shortcomings of Child Protection Services (1997); Scott J. Preston, Note, "Can You Hear Me?":
The United States Court of Appeals for the Third Circuit Addresses the Systemic Deficiencies of the Philadelphia Child
Welfare System in Baby Neal v. Casey, 29 Creighton L. Rev. 1653 (1996).
- Shelly Gehshan, A Step Toward Recovery ii (1993).
- See Infant Mortality on Rise in Ô97, Post & Courier (Charleston, S.C.), Feb. 19, 1999 TA
\l ÒInfant Mortality on Rise in Ô97, Post & Courier (Charleston, S.C.), Feb. 19, 1999Ó \s
ÒInfant Mortality on Rise in Ô97, Post & Courier (Charleston, S.C.), Feb. 19, 1999Ó \c 3 , at
B1; See The Annie E. Casey Foundation, Kids Count Data Book 160 (2001), http://www.aecf.org/kidscount/kc2001,
(reporting that infant mortality decreased from 11.7 in 1990 to 8.4 in 1996, but increased to 9.6 for 1997 and 1998,
the two years following the Whitner decision).
- The National Center on Addiction and Substance Abuse at Columbia University, No Safe Haven, iii
(January 1999) ("Few caseworkers and judges who decide for these children have been tutored in substance abuse and
addiction. While most child welfare officials say they have received some training, usually it involves brief, one-shot
seminars that last as little as two hours. For judges, training tends to be on-the-job. Such training is woefully
inadequate for the profound decisions that these officials are called upon to make for these vulnerable
- Associated Press, Woman Given Labor Sedative Loses Custody of Children, The Sacramento Bee, Feb. 11,
2000 (describing a California woman who lost custody of her newborn and other children for three months based on a drug
test of the newborn that reflected a sedative given to the woman during labor);
- See, e.g., Cathy Singer, The Pretty Good Mother, Long Island Monthly, Jan. 1990, at 46 (reporting
that a mother who had smoked marijuana to ease labor pain lost custody of her baby even though all involved in her case
argued she would be an excellent and loving parent); Cathy Zollo, When Policy Meets Reality, Times Record News (Wichita
Falls, Texas), Nov. 11, 1999 (reporting a case in which the state took into emergency custody a newborn and three older
siblings based on a single positive marijuana test on the newborn); Melissa Hung, Reefer Madness? Angela Took a Hit.
And CPS Took Her Babies Away, Houston Press, Nov. 4, 1999, at 8 (reporting another Texas case in which the child
welfare agency removed custody of a newborn and a one-year-old sibling based solely on a positive drug test for
- Case papers on file with NAPW. See also Center for Substance Abuse Treatment, Pregnant,
Substance-Using Women 18-21(1993) (U.S. Dept. of Health & Human Servs. Publication No. (SMA) 93-1998; Center for
Substance Abuse Treatment, State Methadone Treatment Guidelines 85-93 (1993) (U.S. Dept. of Health & Human Servs.
Publication No. (SMA) 93-1991) (discussing efficacy and safety of methadone treatment for pregnant and breastfeeding
- Ira Chasnoff et al The Prevalence of illicit-drug or alcohol use during pregnancy and discrepancies
in mandatory reporting in Pinellas County, Florida, 322 N. Eng. J. Med 1202-1206 (1990).
- See Brenda Warner Rotzoll, Black Newborns Likelier to be Drug-Tested: Study, Chicago Sun-Times (Fri
March 16, 2001) (noting that "Black babies are more likely than white babies to be tested for cocaine and to be taken
away from their mothers if the drug is present, according to the March issue of the Chicago Reporter").
- Dorothy Roberts, The Challenge of Substance Abuse for Family Preservation Policy, 3 J. Health Care
L. & Pol’y 72, 84 (1999); See also Dorothy E. Roberts, Access to Justice: Poverty, Race and New Directions in
Child Welfare Policy, 1 Wash. U. J.L. & Pol’y 63 (1999) ("If an outsider looked at the American child welfare
system, she would likely conclude that this is not a system designed to promote the welfare of America’s
children. Rather, it is a system designed to regulate, monitor, and punish poor families, especially poor Black
- Memorandum from Dr. Wendy Chavkin to Jane Spinak and Danny Greenberg; "Position Paper on Government
Action of In Utero Drug or Alcohol Exposure" (May 24, 1996) (on file with NAPW).
- Center for the Future of Children, Recommendations, in The Future of Children 8 (Richard F. Behrman
ed., 1991) ("[A]n identified drug exposed infant should be reported to child protective services only if factors in
addition to prenatal drug exposure show that the infant is at risk for abuse or neglect.").
- See Center for Substance Abuse Treatment, Pregnant, Substance-Using Women 6 (1993) (U.S. Dept. of
Health & Human Servs. Publication No. (SMA) 93-1998) (discussing the services needed to address successfully the
treatment of drug using women, noting that it "is imperative that programs include services designed specifically for
women, particularly pregnant women"); see also Center for Substance Abuse Treatment, Practical Approaches in the
Treatment of Women Who Abuse Alcohol and Other Drugs 124-26 (1994) (U.S. Dept. of Health & Human Servs. Publication
No. (SMA) 94-3006) (providing guidance to treatment providers to meet the specific needs of women with substance abuse
- See e.g., Patt Denning & Jeannie Little, Harm Reduction in Mental Health, Harm Reduction
Communication (Spring 2001). (One can also predict the likelihood of developing problems with drug use based on
traumatic experiences: "up to 80% of people with a history of significant trauma will abuse substances."). See also
Women and Drug Abuse, NIDA Capsules (June 1994) (Among drug using women, 70% report having been abused sexually before
the age of 16; and more than 80% had at least one parent addicted to alcohol or one or more illicit drugs); Marsha
Rosenbaum, Women: Research and Policy, in Williams & Wilkins, Substance Abuse 654-65 (1997) ("Researchers have
consistently found high levels of past and present abuse in the lives of women drug users. Many have suggested that
there is a relationship, if not absolutely causal, between violence experienced by women and drug use"); Jahn L.
Forth-Finegan, Sugar and Spice and Everything Nice: Gender Socialization and Women’s Addiction – A
Literature Review, in Feminism and Addiction 25 (Claudia Bepko ed., 1991) ("Difficult and physically abusive childhood
experiences are reported to be frequent, and the incidence of sexual abuse among alcoholics has been shown to be very
high, often as high as 75% of the women in treatment.
Last modified: 21 Mar 2006
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