S. Dakota to enforce treatment of pregnant moms who drink

May 24, 1998
Web posted at: 2:24 p.m. EDT (1824 GMT)

SIOUX FALLS, South Dakota (AP) -- South Dakota on July 1 becomes the first state to allow judges to order pregnant women who drink into alcoholism treatment.

Legislators passed three laws in March to try to cut the number of cases of fetal alcohol syndrome, a lifelong condition that leaves its victims mentally and physically disabled.

"They should throw those women in jail and make them get four or five months of treatment. No question about it," says Dr. Lucy Reifel, who adopted a baby suffering from the syndrome.

Reifel, a physician on the Rosebud Sioux Indian Reservation, took in Casey White Hat after convincing his birth mother that he would be better off living with sober parents.

Factoid: Fetal alcohol syndrome afflicts one out of every 500 children in the United States.

Casey, now age 16, is the size of a scrawny 11-year-old. His coordination is bad, his language skills poor. Frequently frustrated when he can't find the right words to express himself, he'll break into gestures and sign language.

"With Casey, the condition is variable," Reifel says. "But others can be profoundly retarded -- so retarded that they function at infant levels."

Fetal alcohol syndrome afflicts one child out of every 500 in the United States. But in some parts of South Dakota, it affects as many as 20 in 500 children, Gov. Bill Janklow said in a speech to the Legislature in January. It is particularly acute on the state's nine Indian reservations.

The state already distributes information about fetal alcohol syndrome to high schools and medical workers, and federal money helps support prenatal programs around the state. But lawmakers felt more was needed.

The statutes passed in March made South Dakota the first state to enact laws specifically designed to force pregnant women with alcohol or drug problems into treatment, according to the National Conference of State Legislatures.

The statutes:

• Allow relatives or friends to commit pregnant women to emergency detox centers for up to two days.

• Allow judges to confine them to treatment centers for as long as nine months.

• Makes drinking while pregnant a form of child abuse.

"There's no guarantee this (law) will help that particular child, but we hope it will help the second, third and fourth babies in a family if the mother stops drinking." — state Sen. Barb Everist, who co-sponsored the legislation

Other states have used that tactic to help social workers intervene when pregnant women are abusing drugs or alcohol.

The procedure for forcing a pregnant woman into treatment is the same as for other addicts. A relative files a petition with a circuit judge, who must receive a written report from a lawyer within five days.

The woman is granted a hearing, after which the judge decides whether to send her to treatment and for how long. The process can take several weeks.

"There's no guarantee this will help that particular child, but we hope it will help the second, third and fourth babies in a family if the mother stops drinking," says state Sen. Barb Everist, who co-sponsored the legislation.

Everist says she pushed for the new laws because fetal alcohol syndrome is "totally preventable." Only women who abuse alcohol, not the occasional drinker, would be forced into treatment, she says.

"A lot of women still don't understand that even small amounts of alcohol can have an effect," she says. "The key is making sure we educate those women."

The U.S. surgeon general first alerted the public 17 years ago about the dangers of drinking while pregnant, but health officials are alarmed by surveys suggesting many women are not heeding the warnings.

In 1995, the Centers for Disease Control and Prevention found that 3.5 percent of 1,313 pregnant women said they had seven or more alcoholic drinks per week or five or more drinks in one sitting. That was up from 0.8 percent of 1,053 pregnant women surveyed in 1991.

In South Dakota, state health officials say 4.7 percent of women surveyed in 1992-96 said they drank during pregnancy.

Alcoholism has been a problem for generations in the towns spread across the South Dakota prairie, where numbing isolation and a lack of good jobs are often blamed.

State Sen. Paul Valandra, a Democrat who represents the Rosebud reservation, says he supports the Legislature's efforts to curb fetal alcohol syndrome but suggests more needs to be done. "There are greater issues of education and economic development at work here," he says.

State laws don't pertain to Indian reservations, but American Indian women who move off reservations or seek medical care elsewhere would be subject to the new laws.

Critics argue the measures will violate individual rights and do little for a fetus already damaged by weeks of drinking.

Ann Wilson, a University of South Dakota professor who studies early child development, says the new laws could alienate women from friends and relatives who could help them.

The causes of fetal alcohol syndrome are unclear, Wilson adds. Alcoholics, especially those living in poverty, often have other health problems that could affect a fetus, she says.

State Rep. Scott Eccarius, an eye surgeon who co-sponsored the legislation, says lawmakers ultimately passed the laws because fetal alcohol syndrome "has become an epidemic."

"There was a fair amount of concern that this would be too hard on women," he says. "But in the end, it turned out to be popular. Frankly, people realize it's not too much to ask that women behave responsibly when they are pregnant."

Copyright 1998   The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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