Should We Take Away Their Kids?

By James Willwerth/Los Angeles

Try, if you can, to imagine the pain and horror of Daniel Scott's last hours. The seven-month-old baby was found by police lying in a pool of blood next to his crib in a Bronx tenement. His mother, off on a six-day crack binge, had left him in the care of his father, who abandoned the child in his unlocked apartment without so much as a bottle of water. Emaciated, filthy, desperate, the infant had apparently hoisted himself out of the crib and tumbled onto the wood floor before finally dying of starvation and dehydration. Both parents -- Jane Scott, 28, and Jose Valdez, 26 -- have been charged with manslaughter.

Confronted by such tragic chapters in the saga of crack, Americans tend to focus on questions of state intervention: At what point should authorities act to remove a child from the home of drug-abusing parents? At birth? When there is clear evidence of abuse or neglect? How about before birth? -- the position of a growing number of people calling for mandatory birth control for female addicts. For Daniel Scott, intervention never came.

Around the country, prosecutors and state legislators have lost patience with what they regard as the softhearted and sometimes softheaded approach of social-service workers. Nineteen states now have laws that allow child-abuse charges to be pressed against any woman who gives birth to a child with illegal drugs in his bloodstream. In some cities local prosecutors have charged such mothers with a felony: delivering illegal drugs to a minor. The means of delivery: the umbilical cord. Floridian Jennifer Johnson, one of the first women convicted in such a case, was sentenced to mandatory drug treatment and 15 years of probation.

In Kansas, state representative Kerry Patrick wants to take the law a step further. He has introduced a bill that would require convicted female addicts to accept Norplant birth-control inserts, which prevent pregnancies for up to five years, if they wish to avoid jail. Under the proposed law, the state would pay for the $500 procedure, and also for its removal if the woman stays clean for a year. Says Patrick: "I've gotten a lot of support from nurses who deal with crack babies. Once you see one, you don't care about the rights of the mother."

Impatience with the niceties of civil liberties is also found among social- service experts. "Damn it, babies are dying out there!" says Dr. Michael Durfee, a child psychologist who tracks child-abuse cases for the Los Angeles County department of health. "You get someone with a terrible family history, stoned, no parenting skills -- and we keep giving back her babies because we don't want to look racist or sexist."

Testimony from many of the addicts themselves seems to support Durfee's argument. Doreen Flaherty, 27, a recovering crack addict from Garden Grove, Calif., remembers spending a week in jail after being arrested for possession of cocaine. "I kept crying in jail because I wanted to see my little girl," she says. "That's all that mattered to me." After she made bail, Doreen did not return home to her daughter but sought out a drug dealer instead. When a girlfriend tracked her down at the crack house, Doreen told the dealer to say she was not there. "How could you do this to your daughter?" the girlfriend asked. "I'm sorry, I'm sorry!" Doreen wailed. "I just needed another hit."

But whisking a baby out of a troubled mother's arms does not ensure an end to the child's travails. Babies who become wards of the state have often wound up being boarded in hospitals for months, tended by ever-changing shifts of nurses. Such institutional care not only leads to emotional troubles down the road but can also actually cause "failure to thrive," a medical term for a condition in which infants do not gain enough weight and fail to develop normally. It has been loosely translated as a loss of interest in life. Older children may be shuttled through a series of foster homes, never learning to love or trust a soul. Staying at home with an addicted mother who is actively participating in a rehabilitation program can, in many cases, be the more promising and safer route for the child. "Foster care is often so poor," says Dr. Evelyn Lipper, director of child development at New York Hospital- Cornell Medical Center. "Maybe these children are better off with their mothers."

Health officials point to another problem with the get-tough approach. Throwing the book at female addicts for everything from delivering drugs to a minor to child abuse makes it even less likely that they will actively seek medical care when they are pregnant. And scaring them away from the clinic means even more damaged babies.

The two U.S. cities with the biggest crack problems have backed away from their initial seize-the-kids approach. Until 1986, Los Angeles County automatically took at least temporary custody of drug-exposed newborns. Then the crack epidemic exploded. "If we took every child who came out with a positive tox screen," says Gerhard Moland, a children's services administrator, "it would overwhelm the system." Now social workers consider the child's health and the mother's potential for rehabilitation when making court recommendations. The biggest factor in determining whether or not the county takes custody: the presence of a sober grandmother. Currently, grandmothers care for more than half of the 1,000 high-risk babies in Moland's district.

New York City has also shifted strategies. In the mid-1980s, under the administration of former Mayor Ed Koch, a single positive toxicology report was enough for authorities to take a newborn from its mother. But a series of cases of mistaken charges of child abuse helped lead to a change of policy under Mayor David Dinkins. In one notorious example, Brooklyn bank clerk Judith Adams lost custody of her child for nearly two months after the medication that doctors gave her during a caesarean section resulted in a false-positive drug test. "Instead of breast feeding my baby, I was looking for lawyers and going to social workers' offices, trying to get him back," ^ she recalls bitterly.

As in most such mishaps, the victim was a black woman at a public hospital. The principal reason the Dinkins administration abandoned the old approach was that it seemed discriminatory. Minority women giving birth in public hospitals are much more likely to be tested for drugs than are white women or patients in private hospitals. But the policy was also abandoned because it did not work. Explains Susan Demers, deputy commissioner and general counsel of the New York State department of social services: "It put the state in the position of destroying families as the quick-and-easy answer to the drug epidemic."

What does seem to work is a combination of the social-services carrot and the legal stick. The most successful programs for addicted mothers offer every kind of assistance, beginning with detoxification but extending to pediatric services for the child, psychological and job counseling for the mother, and extensive parenting classes. But all this is backed up with a none-too-subtle threat of legal intervention. The Women and Infants Clinic program at Boston City Hospital, for instance, takes this approach to helping addicted mothers. Women in the program must submit to random urine tests each week, and they are told that two unexplained absences in a row will trigger an immediate investigation for child neglect.

In many cities, a mother whose newborn tests positive for cocaine is given a choice: enter a treatment program or give up the child. This ultimatum can work surprisingly well, provided that a good program is available. Margaruite Custode was offered the choice between jail and treatment last June and picked the latter, figuring that she would dry out, get her baby back and get high again. Custode, a 30-year-old New Yorker, had been through detox before, and the treatment never stuck. She had lost custody of two previous children. But this time she entered a program at Daytop Village designed for mothers. To her amazement, she found that within a month she began to connect with other women in the program and to care about getting clean. "The fact that we are viewed as unfit mothers by society is one of the things that bonds us together," she says.

Drug-treatment experts have found that methods that work with men often backfire with women. "Women will not be spoken to harshly or in a condescending manner," says Eugene Williams, coordinator of a treatment program in East Palo Alto, Calif. "Nor is it profitable to accuse them of lying or not toeing the mark as we do in men's programs." Many women addicts turned to drugs because they were sexually abused or raped as children, and they need help repairing the damage. Says Custode of her sessions with other female addicts: "We share some sick secrets with each other that we wouldn't want to share with the opposite sex."

Two things are clear from the case of Margaruite Custode -- and many others like hers. First, if it were not for the threat of losing legal custody, she would not have sought treatment for her drug habit. Second, if it were not for the all too rare opportunity for first-rate treatment, she would not be sober for nine months straight with a good chance of regaining custody of her child. Whether Custode will be a good parent is impossible to say, but both social- service workers and law-enforcement officials are finding that the best way to rescue a child is to rescue the mother as well.

With reporting by Mary Cronin and Christine Gorman/New York