Chapter 8 - Fetal Abuse

Test Items: a. 1% b. 3% c. 5% d. 10%

1. Based on data from the National Survey on Drug Use and Health, it is estimated that approximately of pregnant women used illicit drugs in the previous 30 days?

Answer: C a. 250,000 b. 500,000 c. 1,000,000 d. 3,000,000

2. The Us. Department of Health and Human Services estimated that fetuses are exposed to substances each year in the United States.

Answer: C

3. Fetal Alcohol Syndrome is a. not linked with intellectual disability b. one of the leading, preventable causes of intellectual disability c. most commonly linked to severe intellectual disability (IQ less than 45)

Answer: B

4. Dysmorphic features, including a flat nasal bridge is associated with prenatal exposure to a. Alcohol b. Marijuana c. Cocaine d. All of the above

Answer: A

5. With regard to prenatal exposure to alcohol, the broadest term is: a. fetal alcohol spectrum disorders (FASD) b. partial FAS (pFAS) c. alcohol related birth defects (ARBD) d. alcohol related neurodevelopmental disorder (ARND)

Answer: A a. Low birth weight b. Respiratory problems c. Sudden Infant Death Syndrome d. All of the above are associated with prenatal exposure to nicotine

6. Which of the following is not associated with prenatal exposure to nicotine?

Answer: D a. alcohol b. over-the-counter drugs c. illegal drugs d. cigarettes

7. Prenatal exposure to appears to have the most dire consequences of all forms of prenatal substance abuse.

Answer: A a. State v. Whitner b. State v. McKnight c. State v. Johnson d. People v. Stewart

8. Which case involved charging a woman with delivering drugs to a minor through the umbilical cord?

Answer: C a. State v. Pfannenstiel b. State v. Whitner c. State v. McKnight d. State v. Johnson

8. Which case marked the first time a woman was charged with child abuse for drug use during pregnancy?

Answer: A a. Stewart was found guilty of homicide by child abuse. b. Stewart was found guilty of child neglect. c. Stewart was found guilty of child endangerment. d. The case was dismissed.

9. Pameala Rae Stewart was charged with failure to deliver support to her child while she was pregnant (she did not avoid drugs, or intercourse, nor did she stay off her feet as ordered). What was the court’s decision?

Answer: D

10. Cornelia Whitner’s son was born with cocaine metabolites in his system. She pled guilty to a. negligent homicide b. manslaughter c. criminal child neglect d. child physical abuse

Answer: C a. Johnson b. Stewart c. Whitner d. McKnight

11. Which of the following women was found guilty of homicide by child abuse?

Answer: D

12. Charles and Shivas argue that the motivation for the prosecution of fetal abuse a. is soley based on concern for the child b. may be about attacking the mother’s character c. is the same regardless of what endangers the fetus (drugs or high-order multiple births)

Answer: B

True/False

1. Maternal depression increases the risk for fetal abuse. Answer: True

2. Cocaine has more negative effects on fetal development than does alcohol.

Answer: False

3. The effects of cocaine on the developing fetus were initially overestimated by researchers and the media.

Answer: True

4. Cocaine has no negative effects on fetal development. Answer: False

5. The number of women who smoke while pregnant seems to be declining in the last 15 years.

Answer: True

6. If a heroin addict uses methadone instead of heroin during pregnancy, their fetus will develop normally.

Answer: False

7. Buprenorphine is thought to be a safer treatment for pregnant women who are addicted to heroin than is methadone.

Answer: True

8. Buprenorphine has no negative effects on the fetus.

Answer: False

9. There is a serious shortage of treatment programs available for pregnant women who are addicted to drugs.

Answer: True

10. Doctors in all U.S. states are mandated to report pregnant women who use substances to Child Protective Services.

Answer: False

11. There is significant public support for the criminal prosecution of pregnant women who use drugs.

Answer: True

12. If a child is prenatally exposed to drugs, they are at an increased risk for being maltreated after they are born.

Answer: True

Short Answer Questions:

1. List five possible causes for fetal abuse.

Answer: Any 5 of these:

Addiction

Depression

Mixed feelings about pregnancy

Problems in interpersonal relationships

History of drinking alcohol before pregnancy

History of being abused or being exposed to violence

Low education levels

Teen mothers who felt “pushed around”

Rarely – perception that the fetus is attacking or depriving the mother

2. Why is it difficult to determine the impact of a drug on fetal development?

Answer: First, many people are polydrug users, so it is difficult to determine the effect on any one drug. Second, drug use during pregnancy often occurs along with other things that are not ideal for fetal development (e.g., poor nutrition, poverty, homelessness, minimal prenatal care). Third, the impact of any drug may be different depending on when during the pregnancy the mother uses that drug.

3. What is fetal alcohol syndrome?

Answer: a series of birth defects resulting from a mother’s consumption of alcohol during pregnancy. Symptoms include intellectual disability, low birth weight, head and face abnormalities, and growth deficiencies

4. Select ONE of the drugs covered in the text, and describe the impact it has on the fetus.

Answers will vary.

5. What racial problem is associated with mandatory reporting of positive drug screens on newborns?

Answer: There is a concern about racial discrimination: minorities have been tested and reported at a higher rate than are Caucasians.

6. What is meant by “civil commitment”?

Answer: the confinement of a person who is ill, incompetent, or addicted to drugs

Additional Case Studies for Chapter 8

1. The article Outcry in America as Pregnant Women Who Lose Babies Face Murder Charges by Ed Pilkington (2011) can be found at http://www.guardian.co.uk/world/2011/jun/24/america-pregnant-women-murdercharges

This article contains information about several cases: Rennie Gibbs, Bei Bei Shuai, and Amanda Kimbrough.

2. The article The Criminalization of Bad Mothers by Ada Calhoun (2012) can be found at http://www.nytimes.com/2012/04/29/magazine/the-criminalization-ofbad-mothers.html?pagewanted=all

This article contains information about the cases of Amanda Kimbrough, Heather Capps, and Hope Ankron.

3. The article Idaho Woman Arrested for Abortion is Uneasy Case for Both Sides by Jessica Robinson (2012) can be found at http://www.npr.org/templates/story.php?storyId=150312812 https://doi.org/10.1111/j.1939-0025.1982.tb01459.x

This articles describes the case of Jennie Linn McCormack who was arrested and charged with using RU-486 to terminate her pregnancy after 9 weeks of pregnancy.

4. Mackenzie et al. (1982) present the case study of a 34 year old pregnant woman who engages in a number of risky behaviors. Although the fetus seems to be developing normally, the authors discuss the best interventions to ensure the continued health of the baby.

Mackenzie, T. B., Collins, N. M., & Popkin, M. E. (1982). A case of fetal abuse? American Journal of Orthopsychiatry, 52(4), 699–703.

Video Suggestions

1. http://www.youtube.com/watch?v=X9ap3Iimimk This 14:50 minute video was produced by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

It is entitled Fetal Alcohol Syndrome: The Biological Basis. The video includes interviews with adoptive parents of children with Fetal Alcohol Syndrome.

2. http://www.youtube.com/watch?v=m7zfJCW9Yco This 56:51 minute video is entitled Fetal Alcohol Spectrum Disorder (FASD). In this video, eight women describe how their use of drugs and/or alcohol during their pregnancies affected their children.

3. http://www.youtube.com/watch?v=vA4GfL-JvFE This 1:31 minute clip comes from NBC 4 News. The story tells of a program to train caregivers who work with infants who are prenatally exposed to drugs. The clip aired on November 24, 2010.

4. http://www.youtube.com/watch?v=dJt-mrZT6-Q This 3:53 minute video clip was produced by NBC News 3. It is entitled Drug Addicted Babies Part I. The story focuses on babies born addicted to opiates and/or prescription drugs. It first aired on May 17, 2012.

5. http://www.youtube.com/watch?v=Efwk-pZSzZU This 3:31 minute video shows a mother telling about the children she had while using cocaine – all of whom were and are totally healthy. She also speaks to the lack of treatment programs available for pregnant addicts. This was recorded April 24, 2009.

6. http://www.youtube.com/watch?v=kk2l5ZkOKK4 This webcast runs 1:42:54. It is titled, Substance Exposed Newborns: Identification, Referral and Treatment. Four professionals from federally funded projects present their findings in a lecture/power point format. The webcast was recorded on Sept. 15, 2009.

7. https://drugabuse.com/alcohol/drinking-while-pregnant/ This short video clip (2 minutes 12 seconds) on Drinking and Pregnancy by DrugAbuse.com discusses the risks of using alcohol while pregnant. Discuss whether educational videos like this are likely to impact rates of prenatal exposure to alcohol. This video was posted on Nov. 24, 2018.

Discussion Topics

1. Encourage students to discuss whether responses to drug use during pregnancy are influenced by maternal race and/or social class. Have students read the following article:

Springer, K. W. (2010). The race and class privilege of motherhood: The New York

Times presentations of pregnant drug-using women. Sociological Forum, 25 (3), 476-499. https://doi.org/10.1111/j.1573-7861.2010.01192.x

2. Brown et al. (2019) provide a fascinating look at the history of the link between alcohol consumption during pregnancy and negative fetal outcomes. While acknowledging that the scientific link was established in the 1960s, they note links dating back to ancient history.

Brown, J. M., Bland, R., Jonsson, E., & Greenshaw, A. J. (2019). A brief history of awareness of the link between alcohol and fetal alcohol spectrum disorder. The Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie, 64(3), 164–168. https://doi.org/10.1177/0706743718777403