Dealing with meth moms.

Methamphetamine is the fastest growing drug threat in the nation. No matter its name--crank, speed, ice or meth--its use is exploding. Women of childbearing age are abusing the drug in growing numbers and lawmakers are re-visiting an old debate: How should the state deal with pregnant substance abusers?

Using methamphetamine while pregnant can increase the risk of premature delivery and can cause heart and brain abnormalities in infants. Premature babies are at risk for many health problems and learning disabilities. Many pregnant methamphetamine users also use alcohol, tobacco or other drugs, making it difficult to pin possible birth defects on a specific substance.

The dilemma of prenatal drug abuse pits the state's interest in healthy pregnancies and babies against pregnant women's rights. Although no state specifically criminalizes drug abuse during pregnancy, debate continues.

Many advocate treatment over punishment. In May, Hawaii became the most recent state to pass legislation aimed at treating women for substance abuse, rather than punishing them. Hawaii's HB 2045--now awaiting the governor's signature--establishes a pilot clinic for addicted mothers that will provide prenatal care, pediatric care and substance abuse counseling. The clinic includes a case management component to ensure the child's well-being. Nineteen other states also have targeted treatment programs for pregnant women.

Hawaii lawmakers discovered that the main reason pregnant women do not seek treatment is that they fear losing custody of the child. The bill's supporters also believe punishment does not stop drug abuse but only deters women from seeking prenatal care.

They may have a point. In 1997, a South Carolina woman was convicted of criminal child abuse after testing positive for cocaine during pregnancy. Her conviction was upheld in Whither v. South Carolina, resulting in mandatory reporting laws throughout the state. In subsequent years, South Carolina saw a drop in the number of pregnant women enrolling in drug treatment programs and an increase in infant mortality rates and abandoned babies.

Currently, 16 states consider prenatal substance abuse to be child abuse under civil statutes. Idaho and Indiana considered legislation last session to make substance abuse during pregnancy a felony, but the bills failed. Tennessee unsuccessfully considered a bill that would re-define child abuse to include prenatal exposure to illicit drugs and would require health professionals to report mothers if newborns test positive for drugs or have a health problem due to prenatal substance exposure.