Criminalizing pregnancy

In 1977 the state of California issued the first indictment against an American woman for the use of drugs while pregnant. Margaret Reyes was charged with two counts of child endangerment for using heroin while pregnant. Since that time “fetal abuse” prosecutions have steadily increased and the allegations have expanded to include charges of child abuse, child endangerment, murder, attempted murder and manslaughter. Of these cases 56 percent have originated in the South, followed by 22 percent in the Midwest, 15 percent in the Pacific and West, and 7 percent in the Northeast. The Unborn Victims Violence Act and the Chemical Endangerment of Child laws have been expanded to include prosecution of women who have refused medical treatment or attempted suicide and subsequently delivered a medically compromised infant. Between 1973 and 2005 59% of the women in 44 states facing prosecution were women of color, and regardless of race, 71% were economically disadvantaged, in addition to possessing minimal education and family histories of violence, drug and sexual abuse. Instead of taking prosecutorial and punitive actions against these vulnerable women we in public health need to become allies with these women and work to advocate for social and economic reforms that will enable pregnant women to make informed choices that are in their and their child's best interest. This can be achieved by increasing awareness of this issue through public forums; informing and instructing healthcare providers and social services agencies; and introducing and supporting legislation that decriminalizes pregnancy.