WEBVTT - Lynn Paltrow on Pregnancy and Drugs 0:00:00.320 --> 0:00:07.720 Hi, I'm Ethan Nadelman, and this is Psychoactive, a production 0:00:07.760 --> 0:00:11.600 of I Heart Radio and Protozoa Pictures. Psychoactive is the 0:00:11.640 --> 0:00:15.040 show where we talk about all things drugs. But any 0:00:15.120 --> 0:00:18.760 views expressed here do not represent those of my Heart Media, 0:00:18.920 --> 0:00:23.480 Protozoa Pictures, or their executives and employees. Indeed, heed, as 0:00:23.520 --> 0:00:26.400 an inveterate contrarian, I can tell you they may not 0:00:26.560 --> 0:00:30.720 even represent my own and nothing contained in this show 0:00:30.840 --> 0:00:33.680 should be used as medical advice or encouragement to use 0:00:33.760 --> 0:00:45.560 any type of drugs. Hello, Psychoactive listeners. Today we're gonna 0:00:45.640 --> 0:00:52.080 go into the challenging and fascinating and sometimes heartbreaking subject 0:00:52.760 --> 0:00:58.880 of pregnancy and criminalization and the law. We're gonna focus 0:00:58.920 --> 0:01:01.520 on the US, but since I know about thirty of 0:01:01.560 --> 0:01:03.800 our listeners are from outside the United States, We're gonna 0:01:03.840 --> 0:01:06.959 make our best effort to make this both fascinating intelligible 0:01:07.000 --> 0:01:09.480 to people all around the world to may be interested 0:01:09.520 --> 0:01:13.640 in this issue. My guest um is probably one of 0:01:13.760 --> 0:01:16.880 the people I most admire in the world's drug policy 0:01:16.880 --> 0:01:19.400 reform and really in the world at large. Her name 0:01:19.520 --> 0:01:24.840 is Lynn Paltrow. She is a brilliant attorney. She founded 0:01:24.880 --> 0:01:28.720 about twenty years ago an organization called National Advocates for 0:01:28.800 --> 0:01:31.880 Pregnant Women, and before that had worked at the Center 0:01:31.920 --> 0:01:34.280 for Reproductive Rights and at the A. C. L Uth 0:01:34.360 --> 0:01:38.560 Project on similar sorts of issues. We have known one 0:01:38.600 --> 0:01:42.399 another for probably close to thirty years, and the best 0:01:42.480 --> 0:01:45.920 way to describe her role and her leadership is that 0:01:46.040 --> 0:01:50.760 she is the really singular figure standing at the intersection 0:01:51.440 --> 0:01:57.360 of reproductive rights and drug policy reform. So, Lynn, thank 0:01:57.400 --> 0:02:01.520 you so much for joining me and my listeners on Psychoactive. 0:02:02.600 --> 0:02:05.560 Thank you for having me. It's really a privilege to 0:02:05.640 --> 0:02:08.960 be here and to have had the opportunity to work 0:02:09.000 --> 0:02:13.560 across issues which are in fact incredibly similar. The war 0:02:13.600 --> 0:02:15.720 on drugs and the war on abortion, in my view, 0:02:15.720 --> 0:02:18.840 are essentially the same thing. Well, you know, listen, I 0:02:18.880 --> 0:02:20.640 should also tell our listeners that this is one of 0:02:20.639 --> 0:02:23.920 the cases where Lynn and I probably agree, not on 0:02:24.760 --> 0:02:28.400 but probably about nine of all the issues. So I 0:02:28.440 --> 0:02:30.320 am going to make you know, a fair minded effort. 0:02:30.360 --> 0:02:32.880 I gave our heads up to play devil's advocate here 0:02:32.919 --> 0:02:34.640 because I don't want this just to sound like a 0:02:34.720 --> 0:02:37.120 love fest between allies, and I want to really draw 0:02:37.200 --> 0:02:40.120 these issues out as best and so Lenn, I just 0:02:40.160 --> 0:02:42.840 want to take us back, first of all, back the 0:02:42.919 --> 0:02:44.760 late eighties early nineties when you and I were both 0:02:44.800 --> 0:02:49.840 getting going on this and crack cocaine was rampant in America, 0:02:50.160 --> 0:02:52.280 and one of the major issues in all of this 0:02:52.800 --> 0:02:56.919 was the so called crack baby, the crack baby women 0:02:57.000 --> 0:03:01.000 smoking crack. New York Times major story front page, you know, 0:03:01.080 --> 0:03:05.040 quoting some professor I rich has Not saying that three 0:03:05.800 --> 0:03:10.160 thousand crack exposed babies are being born each year and 0:03:10.200 --> 0:03:12.840 he's going to show up into schools and it's devastating 0:03:12.880 --> 0:03:15.440 their lives. And you know, bring us back to that 0:03:15.520 --> 0:03:18.639 time for how it looked from where you were sitting. Well. 0:03:18.960 --> 0:03:23.400 In fact, in terms of criminal law response to the 0:03:23.480 --> 0:03:27.079 issue of pregnancy and drug use, there were some cases 0:03:27.240 --> 0:03:30.080 before the crack baby scare. There was a California case 0:03:30.240 --> 0:03:32.639 in which a woman who had been pregnant with twins 0:03:33.320 --> 0:03:38.560 was arrested because she had been using opioids. She was 0:03:38.960 --> 0:03:43.320 using heroin. So it wasn't the original, but the crack 0:03:43.360 --> 0:03:47.200 baby myth, the claim that there were a group of 0:03:47.240 --> 0:03:50.760 women and they were portrayed as if they were black 0:03:51.320 --> 0:03:55.960 only black women were using a drug, despite the fact 0:03:56.000 --> 0:03:59.080 that they knew or should have known, that it would 0:03:59.160 --> 0:04:03.920 cause per minent, irreparable damage to their children. And when 0:04:03.960 --> 0:04:07.040 I give talks, I often use slides from that period 0:04:07.040 --> 0:04:11.520 of time from Time magazine and the New York Times, 0:04:11.600 --> 0:04:15.760 and they were quite explicitly racist. Every baby was black, 0:04:16.160 --> 0:04:18.800 Every mother who used the drug was black. And the 0:04:18.880 --> 0:04:21.640 question I always had is, if somebody had said, there's 0:04:21.680 --> 0:04:26.320 a drug white mothers are taking, White pregnant women are taking, 0:04:26.760 --> 0:04:29.720 and it harms their babies, it reduces their i Q. 0:04:30.560 --> 0:04:32.400 But the white women are taking in any way, I 0:04:32.440 --> 0:04:34.720 think the journalists would have said, wait a minute, show 0:04:34.760 --> 0:04:38.240 me the research. Tell me how you know that it 0:04:38.360 --> 0:04:41.400 is causing this harm and why these women would be 0:04:41.440 --> 0:04:47.600 using it. The journalists were extraordinarily willing to repeat information 0:04:47.640 --> 0:04:53.480 that had no foundation in evidence based research, didn't ask 0:04:53.600 --> 0:04:57.000 for the proof, and exaggerated it even further, to the 0:04:57.040 --> 0:05:00.440 extent that years and years later, the New York Times 0:05:00.720 --> 0:05:03.760 did an apology. The editorial board had to do an 0:05:03.800 --> 0:05:10.000 apology for furthering and defining this so called crack baby myth. 0:05:10.720 --> 0:05:14.159 Are there substances that would we love people not to use, 0:05:14.400 --> 0:05:18.840 whether they're pregnant or not. Yes. At the same time, 0:05:18.960 --> 0:05:23.200 are they ones that caused permanent, irreparable harm. Uh, The 0:05:23.279 --> 0:05:27.000 answer is no, and the research never existed to support 0:05:27.000 --> 0:05:29.960 the claims being made. So Lynn, I think for most people, 0:05:30.000 --> 0:05:34.440 I've encountered the notion that a woman who's doing that 0:05:34.520 --> 0:05:38.400 stuff and who's using drugs in that way, UM, it 0:05:38.400 --> 0:05:41.479 almost seems beyond imagination. And I think that's not just 0:05:41.560 --> 0:05:44.400 true thirty years ago, but probably even true today that 0:05:44.480 --> 0:05:46.600 they make that assumption. So I mean, how do you 0:05:46.640 --> 0:05:50.600 deal with that? I think we have to meet everyone 0:05:50.680 --> 0:05:53.720 where they're at, and in a country that did see 0:05:53.760 --> 0:05:57.400 at one point that when women used a little mitter 0:05:57.560 --> 0:06:03.960 DS two medications that caused actually caused serious damage in 0:06:04.000 --> 0:06:08.839 the children exposed prenatally. It's understandable that people have concerns 0:06:08.880 --> 0:06:13.440 about various drugs and other things that pregnant women use 0:06:14.360 --> 0:06:17.960 or are exposed to. But what's really interesting is which 0:06:18.040 --> 0:06:22.080 ones we tend to focus on, UH and the level 0:06:22.160 --> 0:06:25.680 of concern. So, first of all, we had this whole 0:06:25.720 --> 0:06:29.799 period and probably maybe ongoing whereas a result of government neglect, 0:06:30.520 --> 0:06:34.159 excessive amounts of leads. Poisonous lead was in the water 0:06:34.400 --> 0:06:38.520 in Flint, Michigan. Poisonous levels of lead because of government 0:06:39.120 --> 0:06:43.880 neglect failure to respond. That is actually a drug, a 0:06:44.000 --> 0:06:49.719 substance that does cause permanent damage, and yet most of 0:06:49.960 --> 0:06:53.480 our ire is focused on a small number of drugs 0:06:53.480 --> 0:06:57.440 that have been criminalized and a small subset of the 0:06:57.720 --> 0:07:02.080 people who use those drugs while they're pregnant. We also 0:07:02.120 --> 0:07:04.880 have to really understand that there's a distinction, or there 0:07:04.880 --> 0:07:08.520 are differences between people who use drugs. Just like most 0:07:08.520 --> 0:07:11.600 people know somebody who drinks alcohol and they're not an alcoholic. 0:07:12.000 --> 0:07:15.679 Most people, including those who are pregnant, who use drugs, 0:07:15.720 --> 0:07:19.400 are using them. They're not dependent. But for those people 0:07:19.440 --> 0:07:23.640 who have a terrible dependency problem, we often assume that 0:07:24.120 --> 0:07:27.400 pregnant people have like superhuman powers, they should be able 0:07:27.400 --> 0:07:32.840 to overcome their addiction instantly, or there perceived as intentionally 0:07:32.960 --> 0:07:37.800 trying to do harm. The good news is that, fortunately, 0:07:38.000 --> 0:07:41.160 the level of harm that people believe exists by using 0:07:41.200 --> 0:07:45.400 any of the criminalized drugs, whether we're talking marijuana, meth amphetamine, cocaine, 0:07:45.480 --> 0:07:48.400 or herron, have not been borne out by the research. 0:07:48.800 --> 0:07:52.800 The risks that are associated with those substances are similar 0:07:52.920 --> 0:07:56.840 to actually cigarettes and poverty and other things that have 0:07:56.960 --> 0:07:59.640 to do with low birth weight and smaller head Cristis 0:07:59.680 --> 0:08:05.800 circle friends, but fortunately none of the criminalized drugs, for example, 0:08:06.320 --> 0:08:11.120 cause miscarriages are still births. Miscarriages are pregnancy losses early 0:08:11.160 --> 0:08:15.400 in pregnancy. Still births are later in pregnancy. And if, 0:08:15.480 --> 0:08:18.000 in fact, the way I explain it sometimes is if 0:08:18.120 --> 0:08:21.440 any of those drugs were good at causing pregnancy loss, 0:08:21.920 --> 0:08:25.360 we'd be shipping them to the people, the pregnant people 0:08:25.440 --> 0:08:28.280 in the states where abortion in the United States has 0:08:28.400 --> 0:08:33.400 now been outlawed. And in fact, I was just preparing 0:08:33.480 --> 0:08:37.880 for this talk, and uh, I was just preparing for 0:08:37.920 --> 0:08:43.319 the talk that we're having, and I found something posted 0:08:43.400 --> 0:08:49.640 by UCSF University of California, San Francisco, a very valued 0:08:50.480 --> 0:08:54.080 provider of health care and research, in which they used 0:08:54.280 --> 0:08:56.680 they didn't use the term crack baby, but they used 0:08:56.760 --> 0:09:01.160 other terms that have absolutely been rejected it by every 0:09:01.240 --> 0:09:04.200 leading medical person in the field. For example, if you 0:09:04.320 --> 0:09:07.000 use a number of they list a number of drugs, 0:09:07.040 --> 0:09:11.640 criminalized drugs and say your baby might will be born addicted. Well, 0:09:11.880 --> 0:09:16.320 no child is born addicted. That's a social definition, a 0:09:16.360 --> 0:09:19.320 psychological social definition that has to do with drug seeking 0:09:19.360 --> 0:09:21.880 behavior and a whole bunch of other things that do 0:09:21.960 --> 0:09:27.280 not describe newborns. And even when newborns have a treatable 0:09:27.320 --> 0:09:31.840 and transitory withdrawal syndrome which only occurs with opioids, that 0:09:32.040 --> 0:09:36.000 is again transitory and treatable. It is not addiction. And 0:09:36.080 --> 0:09:39.200 yet they're still using the word. In fact, if the 0:09:39.280 --> 0:09:43.439 baby is properly taken care of, just held, held, more swattled, 0:09:43.480 --> 0:09:47.840 more treated better, maybe given some withdraw medication, that baby 0:09:47.920 --> 0:09:49.840 is going to grow up and be every bit as 0:09:49.880 --> 0:09:55.160 healthy as a baby whose mother never used opioids whatsoever. Right, Well, yes, 0:09:55.240 --> 0:09:57.640 and and I'd like to be able to tell you 0:09:57.679 --> 0:09:59.880 a story about the correct baby myth. But let me 0:10:00.000 --> 0:10:03.360 to say, after the crack baby myth became, came the 0:10:03.440 --> 0:10:06.480 meth baby myth, and came they you know, exposed to 0:10:06.760 --> 0:10:11.840 opioids myth, that there is a framework that was established 0:10:11.880 --> 0:10:15.880 primarily on the backs of black mothers, and for people 0:10:15.960 --> 0:10:19.480 interested in really understanding that, I recommend Dorothy Robert's book 0:10:19.559 --> 0:10:22.760 Killing the Black Body, a myth that then has been 0:10:22.840 --> 0:10:27.520 replicated and applied more to more and more people, including 0:10:27.920 --> 0:10:30.320 a lot of poor white women, who are the majority 0:10:30.360 --> 0:10:34.080 of those who in recent years have been arrested based 0:10:34.160 --> 0:10:38.160 on claims of harm or risk of harm by using 0:10:38.559 --> 0:10:42.079 meth amphetamine or opioids during pregnancy. One of the earlier 0:10:42.120 --> 0:10:45.520 cases I worked on was a challenge to the Medical 0:10:45.600 --> 0:10:49.560 University of South Carolina's policy of secretly searching their black 0:10:49.640 --> 0:10:53.760 pregnant patients for evidence of cocaine use, and if they 0:10:53.800 --> 0:10:56.520 were positive, they didn't offer them any kind of treatment. 0:10:56.640 --> 0:10:59.800 They pretended they did, but they actually had no treatment 0:11:00.120 --> 0:11:03.880 in their hospital anywhere in the Charleston area where they were. 0:11:04.480 --> 0:11:08.160 They would turn that confidential information medical information over to 0:11:08.200 --> 0:11:12.600 the police and help coordinate their arrest from their hospital beds, 0:11:12.679 --> 0:11:16.280 taking them out in chains and shackles near the oldest 0:11:16.280 --> 0:11:19.760 slave market in the United States, while some of them 0:11:19.800 --> 0:11:23.560 were still pregnant and others were bleeding, still bleeding from 0:11:23.600 --> 0:11:27.400 just having given birth. We brought a bunch of lawsuits. 0:11:27.600 --> 0:11:30.040 One of them went to the Supreme Court. We actually 0:11:30.120 --> 0:11:33.920 won in having the Supreme Court at the in those days, 0:11:34.000 --> 0:11:36.000 the U. S. Supreme Court in those days, saying that 0:11:36.040 --> 0:11:39.079 this was a violation of their rights to be free 0:11:39.120 --> 0:11:42.280 from illegal searches and seizure since they were being drug 0:11:42.360 --> 0:11:47.280 tested was really a secret criminal search. After we while 0:11:47.320 --> 0:11:49.880 we were doing these cases, we actually did focused groups 0:11:49.920 --> 0:11:54.960 in South Carolina to find out what could we say, 0:11:55.000 --> 0:11:58.480 what could we teach, what could we offer to help 0:11:58.520 --> 0:12:05.080 people move away from the rampant mythology about the harms 0:12:05.160 --> 0:12:10.080 done specifically by the smokable form of cocaine crack and 0:12:10.200 --> 0:12:15.360 people's reluctance to think about science and think about evidence 0:12:15.400 --> 0:12:19.000 based research, and what was one of the fascinating things 0:12:19.000 --> 0:12:22.440 that came out of it. People were willing to support 0:12:22.480 --> 0:12:25.360 a tax increase for some kinds of treatment. I worry 0:12:25.400 --> 0:12:28.599 that it was about in their minds, forced treatment, But nevertheless, 0:12:28.760 --> 0:12:33.680 they were willing to think about treatment versus incarceration. But 0:12:33.840 --> 0:12:39.280 when we asked, is there any messenger you would believe 0:12:40.800 --> 0:12:43.520 who told you that there is no such thing as 0:12:43.520 --> 0:12:46.440 a crack baby? In other words, exposure prenatally to crack 0:12:46.559 --> 0:12:50.559 does not cause any unique harm or syndrome or anything 0:12:50.600 --> 0:12:54.240 else that anybody can identify. Would you believe it if 0:12:54.280 --> 0:12:56.560 it was the governor of South Carolina, if it was 0:12:56.600 --> 0:12:59.160 the surgeon General of the United States of American We 0:12:59.240 --> 0:13:02.240 practically said that if if God came down and told you, 0:13:02.240 --> 0:13:04.600 would you believe it? They all said no, I saw 0:13:04.679 --> 0:13:07.880 one on TV, I held one, or they were told 0:13:07.920 --> 0:13:10.800 they held one and the people who we hired to 0:13:10.840 --> 0:13:14.400 do the focus groups advised us to just not even 0:13:14.440 --> 0:13:17.480 talk about it, not even address it. But the problem 0:13:17.520 --> 0:13:22.800 is when people are being prosecuted for something that's scientifically impossible, 0:13:23.600 --> 0:13:27.200 causing a harm that never occurred, or treating a positive 0:13:27.240 --> 0:13:29.720 drug test as if it's harm, we have to talk 0:13:29.720 --> 0:13:32.480 about it, and we have to hope that eventually enough 0:13:32.559 --> 0:13:35.560 people are willing to listen so that we can focus 0:13:35.600 --> 0:13:39.920 on real harms, poverty, lead in the water. Right, Well, listen, 0:13:39.960 --> 0:13:41.240 you know, I mean I was looking at you. You 0:13:41.280 --> 0:13:43.160 have a whole set of fact sheets on the on 0:13:43.200 --> 0:13:46.400 the website for National Advocates for Pregnant Women, one that 0:13:46.440 --> 0:13:48.440 just went up a few months ago, and Prenatal drug 0:13:48.480 --> 0:13:52.120 and alcohol exposure science refutes media hype and enduring this. 0:13:52.280 --> 0:13:55.000 So let's before we leave this issue behind, just for 0:13:55.040 --> 0:13:58.400 our listeners, just to be clear, My understanding is that 0:13:58.440 --> 0:14:02.680 when it comes to for example, women who while pregnant 0:14:02.760 --> 0:14:06.280 are using cocaine or using it as serious, even people 0:14:06.360 --> 0:14:10.400 are addicted in smoking crack or using smoking meth amphetamine, 0:14:10.679 --> 0:14:14.679 that basically what one finds is that it's not associated 0:14:14.720 --> 0:14:17.280 with miscarriage and stillborn. You can't or you can't see 0:14:17.280 --> 0:14:21.200 any causal relationship there, that there is a greater likelihood 0:14:21.280 --> 0:14:23.920 of the baby being born a few weeks prematurely and 0:14:24.000 --> 0:14:27.200 of being born with a smaller head and maybe some 0:14:27.280 --> 0:14:30.680 other little you know, conditions of irritability or whatever, but 0:14:30.800 --> 0:14:33.600 that as that child grows up, if they're given any 0:14:33.640 --> 0:14:37.160 sort of proper care like any other kid, that essentially 0:14:37.280 --> 0:14:41.080 the distinction between that baby at birth and other babies 0:14:41.440 --> 0:14:45.480 essentially disappears as they grow up. Um, what would you 0:14:45.520 --> 0:14:48.360 say about that? What's known about the current evidence? I 0:14:48.400 --> 0:14:52.960 think that's a fair summary. What concerns me is that 0:14:53.200 --> 0:14:57.480 we tend to focus on the effects of certain drugs 0:14:57.560 --> 0:15:01.200 and not others, certain circumstances and not others, and those 0:15:01.280 --> 0:15:06.280 tend to match the idea of individual responsibility, that the 0:15:06.280 --> 0:15:10.480 health of children in the United States is primarily about 0:15:10.680 --> 0:15:15.880 the individual circumstances of the pregnant person's life and not 0:15:16.280 --> 0:15:22.040 the larger environmental hazards they face, poverty, lack of nutrition, 0:15:22.160 --> 0:15:25.280 lack of access to treatment, including drug treatment if they 0:15:25.280 --> 0:15:29.240 want it. So, yes, there are some risks associated with 0:15:29.760 --> 0:15:34.440 the use of various substances, including criminalized drugs, but people 0:15:34.520 --> 0:15:38.200 often confuse risk with harm, so you if you do 0:15:38.240 --> 0:15:42.760 a study that finds that there is a risk of 0:15:43.800 --> 0:15:49.160 lower birth weight an increased risk of smaller head circumference, 0:15:49.600 --> 0:15:53.800 people then mistake that for your baby will be born prematurely, 0:15:53.880 --> 0:15:56.440 your baby will be born with a smaller head circumference. 0:15:56.520 --> 0:15:58.880 And yes, it is true that lots of things babies 0:15:58.920 --> 0:16:04.080 are born with do not affect their whole lives, as 0:16:04.160 --> 0:16:08.200 you explained. At the same time, it's still is so 0:16:08.280 --> 0:16:12.400 easy for people to confuse a risk of harm which 0:16:12.440 --> 0:16:16.239 means most of the time it doesn't happen, and actually 0:16:16.360 --> 0:16:20.880 increasing harm. And there is this expectation that the people 0:16:20.920 --> 0:16:24.920 who get pregnant are going to be able to readjust 0:16:24.960 --> 0:16:28.360 their lives so that they don't engage in any behavior 0:16:28.440 --> 0:16:32.480 that anybody at any time in history has suggested risks harm. 0:16:32.560 --> 0:16:37.320 But nobody can guarantee a healthy outcome. Nobody can guarantee 0:16:37.560 --> 0:16:42.440 that a birth, a pregnancy will continue to birth. All 0:16:42.560 --> 0:16:46.320 pregnancies having nothing to do with prenatal exposure to anything 0:16:47.000 --> 0:16:50.960 end in miscarriage or still birth. And it's sort of 0:16:51.080 --> 0:16:55.880 tragic that we have a culture uh that focuses on 0:16:56.080 --> 0:16:59.800 individual blame and the women, the people who are pregnant 0:16:59.800 --> 0:17:03.080 them selves believe that there must have been something they 0:17:03.120 --> 0:17:06.040 did wrong or could have done differently that would have 0:17:06.080 --> 0:17:10.200 affected the outcome. And psychologically that's understandable. We don't want 0:17:10.200 --> 0:17:13.240 to feel that we don't have control over our own lives, 0:17:13.359 --> 0:17:17.399 our destiny, our pregnancies. But the fact is there is 0:17:17.440 --> 0:17:21.720 relatively little that the people can do, and nor and 0:17:21.800 --> 0:17:25.680 healthcare providers can do to ensure that there isn't gonna 0:17:25.680 --> 0:17:31.320 be a still birth, miscarriage, or another health problem. So, yes, 0:17:31.480 --> 0:17:35.280 that information is true, but it's also true about a 0:17:35.320 --> 0:17:38.040 whole bunch of things, including poverty, which we probably have 0:17:38.080 --> 0:17:43.080 a lot more control over than uh illicit or criminalized drugs. 0:17:45.280 --> 0:18:02.560 We'll be talking more after we hear this ad. Basically, 0:18:02.600 --> 0:18:04.520 if you're looking at women who are living in a 0:18:04.560 --> 0:18:08.439 situation of poverty, disorderly lies, you know, no access to 0:18:08.480 --> 0:18:13.080 prenatal care, um that basically you won't see any difference 0:18:13.200 --> 0:18:16.879 between the mother's living in that condition who do use, say, cocaine, 0:18:16.920 --> 0:18:20.520 and those who don't. And also that conversely, if you 0:18:20.560 --> 0:18:22.440 want to take say a mother who's growing up in 0:18:22.480 --> 0:18:24.919 all those conditions of poverty and poor diet and lack 0:18:24.920 --> 0:18:29.760 of prenatal care, etcetera, etcetera, and not otherwise using you know, 0:18:29.800 --> 0:18:33.680 illicit drugs or even other psychoactive drugs. And then compare 0:18:33.720 --> 0:18:37.240 that with a woman who in fact is living a 0:18:37.320 --> 0:18:41.199 relatively healthy existence and has access to prenatal care and 0:18:41.240 --> 0:18:44.159 has good diet, but happens to be using cocaine on 0:18:44.160 --> 0:18:48.480 a regular basis that by and large, the mother who's 0:18:48.480 --> 0:18:51.600 otherwise leading a healthy life but using cocaine or heroin 0:18:52.040 --> 0:18:55.040 is gonna have that much better a chance of producing 0:18:55.040 --> 0:18:56.960 a healthier baby than is going to be the woman 0:18:57.000 --> 0:18:59.639 who's living in poverty and using no drugs whatsoever. It 0:18:59.720 --> 0:19:02.440 really is the broader conditions, and that similarly, as the 0:19:02.520 --> 0:19:04.879 kids growing up, it has much less to do with 0:19:04.960 --> 0:19:07.280 their with whether or not their mother used drugs when 0:19:07.320 --> 0:19:09.520 she was pregnant with them, and a lot more to 0:19:09.560 --> 0:19:11.760 do with are they growing up in poverty, are they 0:19:11.760 --> 0:19:14.399 being exposed to violence and ways that reminds them, to 0:19:14.480 --> 0:19:17.439 emotional abuse, to physical abuse, That those things have a 0:19:17.520 --> 0:19:21.399 much bigger impact than any drug use does per se. 0:19:22.040 --> 0:19:25.480 And it's clear to me that the issue of drug 0:19:25.560 --> 0:19:29.680 use and pregnancy is used purposely as a brilliant distraction 0:19:30.359 --> 0:19:34.760 that what does trauma do to a pregnant woman's body. 0:19:34.920 --> 0:19:39.080 What does increase cordials all levels, and those are stress 0:19:39.200 --> 0:19:46.160 hormones that come from unrelenting racism, daily assaults on your 0:19:46.320 --> 0:19:50.760 humanity because of the color of your skin. Those have impacts. 0:19:50.800 --> 0:19:54.479 And if we focus on drugs, on something we claim 0:19:54.800 --> 0:19:58.400 or allege that a pregnant person is doing, we don't 0:19:58.440 --> 0:20:03.639 have to address the pervace of weathering impacts of racism. 0:20:03.760 --> 0:20:06.959 And weathering is a term that refers to the lifelong 0:20:07.080 --> 0:20:10.679 build up a stress before somebody ever becomes pregnant that 0:20:10.840 --> 0:20:13.720 makes it less likely that they will have a healthy 0:20:13.720 --> 0:20:17.080 pregnancy and that they will survive being pregnant, giving her 0:20:17.840 --> 0:20:21.720 The drug war has, in many ways, and particularly here, 0:20:22.400 --> 0:20:27.040 been used to keep us from looking at underlying foundational 0:20:27.119 --> 0:20:30.879 issues that keep people, particularly in the US where there 0:20:31.000 --> 0:20:36.680 is no universal healthcare, there is no government supported childcare, 0:20:37.119 --> 0:20:41.520 from focusing on those things because we reinforced not just 0:20:41.560 --> 0:20:44.399 the specific things like the crack baby myth, but the 0:20:44.440 --> 0:20:47.960 myth that these are things that individuals alone are responsible. 0:20:48.240 --> 0:20:50.440 I also noticed it in your materials. There was one 0:20:50.520 --> 0:20:53.800 really a point that really caught my attention. You pointed 0:20:53.840 --> 0:20:59.879 out at seventy percent of women take a prescription to 0:21:00.040 --> 0:21:05.480 rug during pregnancy and in fact take some drug over 0:21:05.520 --> 0:21:08.879 the counter, prescription whatever in total, but that only about 0:21:08.880 --> 0:21:12.639 a dozen of all drugs that people are taking have 0:21:12.720 --> 0:21:15.919 been approved for use by pregnant women, I think in 0:21:15.960 --> 0:21:19.239 part because of the difficulties of conducting such studies. So 0:21:19.400 --> 0:21:21.199 I mean it is to say that there's you know, 0:21:21.359 --> 0:21:24.159 commonly doctors are prescribing things and when women say, if 0:21:24.160 --> 0:21:26.040 this is this okay to use during my pregnancy, that 0:21:26.119 --> 0:21:29.560 doctor doesn't really have an answer because there's not real 0:21:29.680 --> 0:21:35.320 research out there. Yes, that that's absolutely true, and you know, 0:21:35.480 --> 0:21:38.679 part of it is that it's not just the difficulty 0:21:38.680 --> 0:21:43.800 of doing the research. It's that there has been very simplistic, 0:21:43.920 --> 0:21:49.080 if you will, or also sexist views of uh, people 0:21:49.080 --> 0:21:52.200 who become pregnant, women who become pregnant as not being 0:21:52.280 --> 0:21:56.159 able to make judgments about participating in research. There's been 0:21:56.200 --> 0:22:00.800 a real effort to change the rules for research on 0:22:00.920 --> 0:22:05.119 human subjects so that more pregnant people are included in 0:22:05.200 --> 0:22:08.600 that research so that we have better information, and we've 0:22:08.640 --> 0:22:12.880 seen some real harm we uh it seems, from excluding 0:22:12.960 --> 0:22:17.200 pregnant women from the COVID studies. But the point though 0:22:17.440 --> 0:22:21.560 is we don't know. People do the best that they can, 0:22:22.320 --> 0:22:25.919 and we have to also understand that people make decisions 0:22:26.080 --> 0:22:32.120 based on experience. Women, pregnant women have been using heroin 0:22:32.240 --> 0:22:37.639 opium morphine for hundreds of years. If babies would be 0:22:37.720 --> 0:22:40.920 in the thousands, if babies were born with two heads 0:22:41.200 --> 0:22:43.560 or kidneys on outside of their body, or any of 0:22:43.600 --> 0:22:50.159 the exaggerated terrifying claims made by some people about pregnant 0:22:50.160 --> 0:22:54.919 women and druggist, we would know that research about cocaine 0:22:55.000 --> 0:23:00.639 was actually used more in the seventies by wealthy why people. 0:23:01.240 --> 0:23:06.080 Then crack was used. Smokable cocaine was used in black 0:23:06.119 --> 0:23:10.600 neighborhoods during the eighties and nineties, where the cocaine babies 0:23:10.760 --> 0:23:17.280 from the seventies. We have an attention to potential harms 0:23:17.400 --> 0:23:21.080 for certain groups of people and an unwillingness to just 0:23:21.119 --> 0:23:24.600 sort of take a deep breath and say, hmm, what 0:23:24.720 --> 0:23:28.120 have I seen in my own community? You know? Did 0:23:28.160 --> 0:23:31.199 I have a drink while I was pregnant? One drink? 0:23:31.320 --> 0:23:35.359 Did that make my baby have fetal alcohol syndrome? No? 0:23:35.720 --> 0:23:40.480 And that doesn't mean we replace the experience with good, 0:23:40.520 --> 0:23:44.240 ongoing scientific research, but it is to say to take 0:23:44.280 --> 0:23:48.960 that step back and start from a place of wait 0:23:49.000 --> 0:23:53.520 a minute, not everybody has these effects. My mother smoked 0:23:53.560 --> 0:23:57.600 through her whole pregnancy. The sides of cigarette packages now 0:23:57.720 --> 0:24:03.400 say it can contribute to significantly less healthy babies. Well, 0:24:03.520 --> 0:24:06.960 I'm a nicotine baby. I didn't have those impacts. It's 0:24:07.000 --> 0:24:10.920 an example of yes, there is research that has a 0:24:11.080 --> 0:24:15.880 risk factor associated with smoking cigarettes, but you cannot look 0:24:15.920 --> 0:24:18.480 at somebody smoking a cigarette and say that baby is 0:24:18.520 --> 0:24:21.160 going to be damaged, that baby is going to be smaller, 0:24:21.200 --> 0:24:23.520 and their life is going to be affected. What would 0:24:23.560 --> 0:24:26.359 be the best thing is to find out from the 0:24:26.440 --> 0:24:29.879 pregnant woman herself, what is it you need? What is 0:24:29.920 --> 0:24:33.040 it that would help you have a healthier pregnancy. And 0:24:33.119 --> 0:24:36.680 it may not be stopping whatever she's dependent on, if 0:24:36.720 --> 0:24:39.240 she has a drug dependency on, but it might be 0:24:39.600 --> 0:24:42.960 get me housing so I'm not totally stressed out living 0:24:42.960 --> 0:24:45.280 in a stairwell. Then I came across a line you 0:24:45.320 --> 0:24:49.560 wrote someplace. You said, since most states criminalized drug possession, 0:24:50.119 --> 0:24:55.320 not drug use, it's the pregnancy. It turns drug use 0:24:55.760 --> 0:25:00.280 into a crime, and those pregnancy is an independent element 0:25:00.320 --> 0:25:03.880 of the crime is imagined by unethical rogue prosecutors, even 0:25:03.920 --> 0:25:07.199 before the Dobb's decision that overturned Row. And we've been 0:25:07.200 --> 0:25:09.159 talking about this in one way or another, but just 0:25:09.240 --> 0:25:15.400 elaborate upon that basic point right there. People often assume 0:25:15.520 --> 0:25:18.600 that there is a crime of drug use, and while 0:25:18.640 --> 0:25:20.840 it sort of ends up working out that way, it 0:25:21.000 --> 0:25:24.399 is possession having it in your pocket, not in your body. 0:25:24.840 --> 0:25:27.359 I think there's a few states which criminalized quote unquote 0:25:27.359 --> 0:25:31.400 internal possession. I think South Dakota, UM, maybe a few others, 0:25:31.440 --> 0:25:33.400 and certainly there are some other countries that do that. 0:25:33.440 --> 0:25:37.280 But basically it's got to be in possession right on 0:25:37.400 --> 0:25:40.480 your body, not in your body. And I think when people, 0:25:40.600 --> 0:25:45.000 because they've gotten so much misinformation when they hear about 0:25:45.800 --> 0:25:48.440 pregnant when being arrested in using drugs, they think there's 0:25:48.440 --> 0:25:51.480 a crime, that there's an actual crime of pregnancy and 0:25:51.560 --> 0:25:55.200 drug use or drug use while pregnant, but there isn't. 0:25:55.320 --> 0:25:59.120 All of these arrests that have happened have been based 0:25:59.200 --> 0:26:02.280 on general all drug delivery laws, and they made them 0:26:02.280 --> 0:26:04.840 about drug delivery to a minor through the umbilical cord 0:26:05.119 --> 0:26:09.440