Policing Pregnancy

Policing Pregnancy

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The Supreme Court opens its new term with a case that raises the stakes dramatically in the politics of fetal rights. At issue in Ferguson v. City of Charleston is whether a public hospital violates the Constitution when it tests pregnant women for drug use and turns over positive results to the police without so much as obtaining a search warrant.

Medical professionals and the general public agree that it is not desirable for pregnant women to use drugs. But this case raises a different question: Do women forfeit basic constitutional rights to equal treatment, due process and protection against unreasonable searches and seizures when they become pregnant?

South Carolina has been a leader in the movement, building ever since Roe v. Wade legalized abortion, to establish rights for fetuses. No state has done more to target pregnant women who use drugs. Starting in 1989, the Medical University of South Carolina (MUSC) invited the police and local prosecutor to help implement a policy directed at prenatal-care patients. Women who came to MUSC, the only facility for indigent patients in Charleston, were threatened with arrest if they tested positive for drugs. Some were jailed for the duration of their pregnancies (surely not an optimal environment for pregnant women’s health), and others were jailed after giving birth, still in their hospital gowns. All but one were black. The crimes they were charged with–drug possession, child neglect and distributing drugs to a minor–carried penalties of two to twenty years.

South Carolina Attorney General Charles Condon has said, “There is no constitutional right for a pregnant mother to use drugs.” True enough. But the Constitution does guarantee rights of personal liberty and due process, which in turn require that all people, regardless of race or gender, be treated fairly and equally under the law. And the Charleston police department has never arrested a male hospital patient and charged him with possessing drugs on the basis of a positive urine test.

The real issue is how to respect pregnant women’s constitutional rights while improving their (and their future children’s) chances of a good outcome. The state maintains that the “stick” of criminal intervention is necessary to make its policy of “encouraging” pregnant women to get treatment effective. But at the time the policy took effect, there was not a single residential drug-abuse-treatment program for women in the entire state. MUSC itself would not admit pregnant women to its treatment center. And no outpatient program in Charleston provided childcare so that pregnant women with young children could keep their counseling appointments.

Finally, arresting women after they give birth does nothing to promote a healthy pregnancy or newborn. This practice also hinders the basic goals of keeping families together and promoting family stability through the provision of rehabilitative services instead of punishment.

Condon has made plain his desire to challenge the premise underlying abortion law: that a fetus is not a person in the constitutional sense and has no rights of its own. In 1998 he told the Washington Times that he would be “proud” and “very pleased” to defend his policies, “even in terms of reversing Roe v. Wade.”

Faced with sanctions and the loss of federal dollars when the federal government investigated MUSC for ethics violations and discrimination against African-American women, the hospital suspended its policy in late 1994. But the program’s architects got a boost when the State Supreme Court ruled in 1996 that a viable fetus is a person under the children’s code, a ruling that the US Supreme Court allowed to stand. Condon then instructed district attorneys around the state to prosecute for “child abuse” women who take drugs during pregnancy.

Because most women in the United States get pregnant at least once in their lives, the practical and political implications of the Supreme Court’s decision in Ferguson v. City of Charleston will be enormous. Fetal rights advocates recently scored a victory in Massachusetts when a judge entered an order of protection on behalf of a fetus and took a pregnant woman into state custody. The state alleges that the woman let her last baby die shortly after birth but has not charged her with any crime. If the Court upholds South Carolina’s policy, it will encourage similar actions, effectively putting American women on notice that if they become pregnant, their lives are no longer their own.

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