When Miscarriages Become Manslaughter
On October 5 2021, a young woman named Brittany Poolaw, a member of Wichita and Affiliated Tribes in Oklahoma, was charged with first degree manslaughter and a sentence of 4 years in prison. She had suffered a second-trimester miscarriage. In a fetal autopsy, examiners found a congenital abnormality and a complication with the placenta in addition to traces of Methamphetamine. Whether or not the Meth ultimately caused Poolaw’s miscarriage is decidedly undeterminable and yet, after a year and a half in an overcrowded jail, amidst the ongoing pandemic, she faces more time behind bars for a heartbreaking loss. And she’s not the only one. As Oklahoma Methamphetamine rates rise somewhat steadily, so too do the number of infants born (or lost) to drug exposure. Between 2015 and 2021, the numbers nearly quadrupled and with them, more and more pregnant women are facing incarceration for drug abuse, even in cases where a woman had a medical Marijuana card and/or her baby was born perfectly healthy.
Healthcare Professionals Weigh In
Poolaw’s case has sparked national outcry. Numerous leaders in women’s health such as the March of Dimes organization, the American College of Obstetricians and Gynecologists (ACOG), and the National Advocates for Pregnant Women (NAPW) as well as 37 Oklahoma-based doctors have released numerous letters and statements of outrage all saying the same thing: incarceration for drug abuse in pregnant women, especially in the unfortunate loss of a pregnancy, is not the answer to the variety of underlying issues at stake. Dr. Kate Arnold, an Oklahoma City OBGYN and vice-chair of the Oklahoma chapter of ACOG believes the state is charging these women “supposedly with the hopes that if we can prosecute it [then] it will deter drug use during pregnancy. The problem that we as physicians see is this has actually already been tried in many other states and it does not improve outcomes. In fact, it leads to worse outcomes.”
In a guest column article Arnold wrote for the online publication, The Oklahoman, she expresses the erroneous nature of incarceration for drug abuse with regard to pregnant women’s health, writing:
These misguided policies disproportionately target low-income women and women of Color, and women who represent communities with limited access to medical care, among other factors contributing to worse health outcomes of them and their children. Studies of drug use in pregnancy suggests that other issues—such as poverty, poor diet, and tobacco use—are at least as harmful as drug use itself.
Considering Assistant District Attorney Christine Gailbraith said Poolaw’s case was, “a situation where the defendant put her wants ahead of the baby. She chose Meth over his life,” Dr. Arnold’s claim provides important context; this increasingly common issue is deeper than “wants.”
Outcomes Of Incarcerating Pregnant Women For Drug Abuse
Both state officials and health professionals ultimately wish the same for pregnant women who suffer from varying substance abuse problems: a healthy mom and a healthy baby. The problem, and what doctors are tirelessly working to inform policymakers of, is that by convicting someone who is likely already under immense duress and trauma (especially in the case of a miscarriage) is both detrimental and ineffective. One local news source investigated Poolaw’s case in conjunction with 45 other pregnant women across the state charged with felony child abuse, neglect, or manslaughter in relation with substance use since 2017. While the findings varied dependent upon county, across the board, only 18 received any kind of rehab/treatment for drug abuse as part of their sentence. The statistic appears counterintuitive to some prosecutor’s claim that criminal justice involvement protects children while simultaneously encourages women to seek treatment. For pregnant women, incarceration for drug abuse is not working.
“I wish we could get more education out to assistant district attorneys and judges to better understand substance use and not criminalize individuals that are pregnant for their substance use,” director for the Oklahoma State Department of Mental Health and Substance Abuse Services, Teresa Stephenson said. Because of these decisions being made across the state, when a woman who suffers from addiction or abuse gets pregnant, she now must weigh her options as to whether or not to seek medical help and consultation, afraid she might be prosecuted for her addiction. Thus, a vicious cycle ensues in which this woman either gets help and risks incarceration or her baby being taken, or she says nothing, doesn’t receive treatment, and still risks losing her baby and/or her freedom, as well as the ability to find and pursue the help and treatment she needs.
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Reducing The Stigma
Another issue, is that even if women like Poolaw, who suffer from substance use or addiction while pregnant, had the ability or opportunity to receive prenatal care, they might have a hard time finding doctors willing to treat them. Medical director of Substance Use Treatment And Recovery Prenatal Clinic (STARS), Dr. Stephanie Pierce believes there is a much greater need for services that cater to women struggling with drug abuse, but there are not enough providers. “There [are] so many people that have these issues and there’s just traditionally not a lot of OB providers that are really interested or excited about taking care of these patients and I think a lot of that is due to stigma,” she said. Despite the relative lack in OBGYNs, The STARS clinic is doing quite well; between October of 2019 and July of 2021, 91% of infants were discharged to their parents’ care.
“Most of these women really want their babies and want to be able to take care of their babies. I think early intervention is probably the most key thing,” said Paula Griffith, director of Women and Children’s Services at Conmache County Memorial Hospital where Poolaw received care during her miscarriage. In October of last year, Poolaw obtained a new attorney, John Coyle III, after her story made headlines and national news, who said that hers is “a sad case and an assault on women’s rights.” A local news source reached out to prosecuting district attorney for Poolaw’s case, Kyle Cabelka, for comment; he declined.