As a little warm-up to next week's bloggerfest at the NAPW summit, I'm finally getting around to the notes I took weeks ago during a conference call with various NAPW folk and fellow bloggers. The issue at hand was a woman named Sherri Lohnstein, her underweight baby who died shortly after delivery, and an article about these events in the St. Louis Post-Dispatch. The story is certainly tragic, and at first glance Lohnstein doesn't make much of a sympathetic character. Her baby weighed about two pounds and was born with a blood alcohol level of 0.17. I have to confess, much as I dig NAPW and what they're doing, I'm slow to get on the defensive side of these stories. But as a member of the public health community (and, you know, a thoughtful human being) I find it a reasonable argument to make that imprisoning this woman for manslaughter is perhaps not the place to begin trying to 'fix' things. As someone on the conference call said, "Many people see a pregnant woman who is drinking or who is using drugs and feel permission to hate her," and fail to ask why that person may be drinking or using drugs.

In Missouri, a trend has developed of hospitals turning patient records over to police, rather than social services, if a pregnant woman comes to them with an addiction problem. Rather than even attempting to provide these women with treatment (which would be a feat in itself, since only one drug/alcohol treatment center in the entire country accepts women with children) they merely wait for her to be arrested.

So, a hypothetical woman, someone like Ms. Lohnstein is in trouble. She knows she's in trouble. But going to her doctor and admitting that she's in trouble is more likely to result in loss of custody of any existing children and potential jail time, than treatment. So why admit to anything in the first place? How is arresting women like Ms. Lohnstein encouraging other women to seek help? How are cases like these improving the health of newborns? They aren't.

If local government really, truly has as its goal improving healthy outcomes for pregnant women, they will stop wasting time indicting them on manslaughter and instead will open treatment centers, will provide avenues for doctors to contact social services instead of the police, and stop creating environments that actively discourage women from seeking medical help. As someone else on the conference call pointed out, these sorts of laws and trials implicitly guarantee a fetus the right to perfect health provided by the woman, yet fails to assist that woman in providing that health.