Stephen Ondersma said Thursday that the controversy surrounding aspects concerning prenatal drug exposure have resulted from misinformation presented through outlets such as the media.
Ondersma, who spoke at the UNM's Center on Alcoholism, Substance Abuse and Addictions, is a clinical psychologist and assistant professor in the Merrill-Palmer Institute at Wayne State University in Detroit, Mich. Ondersma conducted two anonymous nationwide surveys that reflected the current responses and opinions regarding prenatal drug exposure.
Ondersma said his original intent was to provide a comprehensive treatment program for mothers of drug-exposed infants. But, he said that whatever direction he turned, he ran into controversy, which led him to conduct the surveys with the hope of identifying a global response toward prenatal drug exposure.
He said that in attempting to determine how prevalent the actual problem is, he discovered that much of the original research was inaccurate about how many babies were being born exposed to illicit drugs.
"Things really went crazy in the late 1980s when evidence came out suggesting that cocaine exposure was particularly damaging," Ondersma said.
He said the reason this became a social problem was that people began noticing the dangers of prenatal drug exposure when crack cocaine gained popularity throughout inner city minority populations, especially among black women.
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The media's image of the drug, he said, became a symbol of all society's fears. The image was the crack baby - a skinny, shriveled infant attached to all kinds of wires.
He said many of these assumptions were based on non-representational samples and that more accurate information could be found in the 1996 National Pregnancy and Health Survey, which was conducted in 1992. The survey indicates that the rate of actual illicit drug use during pregnancy is much lower than first thought. He said that according to the survey, the rate of alcohol and tobacco exposure is far more common than illicit drug exposure.
Ondersma said other difficulties in establishing policy include determining whether prenatal drug exposure is a crime or a disease and whether it should be taken to the civil or criminal courts. He said that only three states in the country have laws that say prenatal drug use is a crime.
He said many issues go into determining whether prenatal drug use should be criminal, including the argument, "If a fetus can be aborted, then is it a person?" He said that after the issue blew up in the media, the initial response was to try these women in criminal courts. But, he said the cases mostly failed because the women were denied due process.
Ondersma said that after questioning child welfare intake supervisors from 100 rural counties and 100 urban counties on whether they received prenatal drug exposure referrals, 90 percent of the counties said they did receive referrals. When asked whether they filed charges against these women, Ondersma said he encountered something he referred to as the "beach ball of confusion."
He reported that 21 percent said they never file charges, 14 percent rarely file and only 25 percent said they almost always file charges. Ondersma said the survey also indicated that most staff in the child welfare programs is comfortable with these decisions.
When 187 criminal district attorneys were surveyed, Ondersma said he found that 39 percent handle prenatal drug exposure cases, but 61 percent do not. He said most policy and practice regarding prenatal drug exposure doesn't make sense and is never consistent.
"It's just a mess out there," Ondersma said.
He said that through his research and surveys, he made a recommendation to begin some sort of public campaign, in which scientists and those in the public health programs could clarify all the misinformation.
Ondersma added that although people in the scientific community should be responsible for giving the correct information, they shouldn't have to make policy or practice.
