Just Call Me “Tennessee Brood Mare”

Rachel has, for your perusal, SB1065/HB0890, which we might call the “The State’s Bodies, Our Selves” bill.  This bill would make manditory drug testing for women who don’t act right during pregnancy.  If you don’t get pre-natal care, the State wants the right to drug test you.  If you don’t come in for prenatal care promptly once the fetus is viable, they want the right to drug test you.  If you don’t get the right kind of prenatal care, they want the right to drug test you.  In other words, if you act in any way “abnormal,” the going assumption is going to be that you must be on drugs.

But here’s the best part.  If your pregnancy just isn’t going right–the placenta comes open or the fetus dies or you go into labor early for no discernible reason, or the fetus isn’t growing fast enough, or the fetus has congenital anomalies–and let me remind you these are all things that just happen during pregnancies; things go wrong, for no reason, all the time–the State wants to drug test you.

And let’s say that they do.  Let’s say that you start to miscarry.  You have spotting and cramping and it’s pretty obvious and inevitable what’s going on.  Maybe you have a bottle of wine to help you through.  You’ve just done into labor early for no discernible reason and your fetus is dead for no discernible reason and when they drug test you, they’re going to find that you’ve been drinking.

What do you think is going to come of that?

This is what I mean when I say that the reproductive rights fight is going to be had on the bodies of women who miscarry.  And these legislators, Hackworth and Marrero are Democrats.  These are the folks who are supposed to be on the side of women and they want to give the State the right to start sniffing around if your pregnancy doesn’t go right?

This bill opens the door to the State blaming women who miscarry for those miscarriages.  Shoot, it doesn’t just open the door.  It opens the door and escorts the State right in.

They cannot make it illegal, still, thank god, for you to be pregnant in your own way.  They cannot legally require you to go to the doctor.  They cannot hold you legally responsible for the death of your fetus.

But they want to.  And so this is an end run around that.  If you won’t do what they want you to do, they will drug test you and force you into treatment if they don’t like what they’ve found.  In other words, you will be punished for, in the case of imbibing alcohol, something that is perfectly legal.  Something most doctors will tell you is fine on occassion when you are pregnant.

In other words, the precident they’re setting is that, once you are pregnant, your body is not your own.  You no longer know what’s best for you.  Your doctor no longer knows what’s best for you.  You are not allowed to not realize you’re pregnant.  You’re not allowed to be afraid.  You’re not allowed to be too poor to go to the doctor.  You have to do what the State tells you to do while you’re pregant, because, while you’re pregnant, your body is not your own.

And here’s the other thing.  Can we just not beat around the bush about the subtext here?  It’s no coincidence that Memphis has an infant mortality rate so depressingly high that it might as well be a hundred years ago over there and that Marrero is bringing the bill.  You cannot be a human being with a soul and look at what’s going on in Memphis, or shoot, in neighborhoods here in Nashville, and not have your heart come right out sobbing into your hands.

But treating women like, once they’re pregnant, the State needs to control them is vile.  It just is.  There’s no way around it and wanting to protect babies doesn’t make it okay to assume that the problem lies solely with the mothers.

If Marrero makes a medical decision I don’t like, should I have the right to force her to take a drug test, make sure she hasn’t been drinking too much?

The sad truth is that pregnancies end for all kinds of reasons.  Some women can go their whole pregancies not even knowing they’re pregnant, drinking and drugging it up, and their kids come out with no ill-effects.  Many, many women in this State try their hardest to do the right thing every step of the way–doctor visits, vitamins, no alcohol use, etc.–and they still lose their pregnancies.  They still have babies who are too sick to make it through the year.  It’s not anyone’s fault.  It just happens.  And I know my fair share of women in that situation and they all blame themselves at some level.  Adding to their suffering by having the state step in and act like they’re to blame is cruel.

And I have to wonder if any doctors were consulted on this, because I have to believe that, even if you’re addicted to crystal meth and crack cocaine at the same time and you’re so desperate for your next heroin fix that you’re licking it off of floors in bathrooms, your OB wants you to come in for prenatal care.  If the option is “drug addicted mother/no care” and “drug addicted mother/care,” the doctor is going to advocate for a patient seeking care, even if and especially if the patient is not in great health.

Threatening to drug test drug addicts if their pregnancies don’t go well is not going to encourage drug addicts to get clean, it’s going to discourage drug addicts from going to the doctor.

And I cannot believe that that’s the outcome Marrero and Hackworth are hoping for.

Edited to add: This has been cross-posted over at Shakesville and the discussion over there is astute and passionate.  I encourage you to check it out.

Edited again to add: This post does a great job of getting at things from a couple of different and important angles.

Edited a third time to add: It’s also being discussed at Feministing now.

Edited yet again to add: Rachel made RADLEY FUCKING BALKO’S blog and I died of jealousy.  Um.  I mean, even the libertarians have been alerted to this.

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27 thoughts on “Just Call Me “Tennessee Brood Mare”

  1. Pingback: Another Example of Why Reproductive Justice Isn’t Just About Abortion « Women’s Health News

  2. Pingback: Invasive Legislation : Post Politics: Political News and Views in Tennessee

  3. I just called Marrero’s office to tell her I’m opposed to that bill. She’s usually quite friendly to women’s rights, so I’m surprised she’s on this.

  4. Stick, I’m shocked too, frankly. I do think that she means well–the infant mortality rate in this state is depressingly high and there are neighborhoods across the state in which it’s an ongoing tragedy. And it’s true that not doing drugs or drinking lowers infant mortality. But so does seeing the doctor. And I cannot see how this results in anything but women with addictions not seeing the doctor.

  5. Does the bill include some guarantee of payment for the doctor visits, etc.? Does it prevent employers from firing or docking the pay of pregnant women who need to take time for doctor visits, etc.? Because I’m willing to bet that it’s money concerns, not drug abuse, that in most cases makes women less likely to go to the doctor.

  6. No office visit coverage? No payment for amniocentecis? For ultrasounds? For prescription vitamins? So if you’re poor (or hovering just above the edge of poverty, not eligible for Medicaid), the only possible explanation is that you’re drug addicted? Loooooovely.

  7. May I add an amendment to that bill, then, that requires elected officials to be drug-tested when they don’t act right.

    They are making decisions that will affect the future of every Tennessean. They should not be hampered in any way in that effort, and drug-testing them whenever they behave in a manner not appropriate to the gravity of their task is one solution.

    (This is what’s called “taking the proposal to the nth degree,” legislators. Consider the consequences.)

  8. Pingback: digg » Blog Archive » Roundup: FOCA a "Mythical Abortion Bill," Says TIME

  9. Well, what constitutes acting right?
    Why is TN all up on us women lately?
    If the state requires it are they gonna foot the bill?
    It’s all another bull shit waste of our tax money.
    We don’t need an adoption bill, we don’t need this bill.
    We need our elected officials to tackle the real issue at the heart of the matter, which is limited health care and spreading poverty. Jeezus

  10. Pingback: mamapundit » Blog Archive » My blood. It boils.

  11. Why is TN all up on us women lately?- cravensworld

    Because the (R)s have been chomping at the bit to have a chance at legislating our reproductive rights again since 2000. That’s when that nasty old Tennessee Supreme Court reversed most of their full-of-crap legislation from 1997. You can read about it here: http://tinyurl.com/boa6oy

    If they pass a Constitutional Amendment (several Joint Resolutions have already been introduced – HJR0061, HJR0066, HJR0088), they can add all the stuff back in that was overturned in 2000.

    Fortunately (in this case), it almost takes a miracle to get a C.A. on the ballot. The resolution has to:

    -Pass in two consecutive sessions of the general assembly.

    -The first passage must be by a majority in each house.

    -The second passage must be by a two-thirds vote in each house.

    -Then it appears on the ballot during the next general election where a governor is selected.

    (Article XI, Section 3, Tennessee Constitution)

    (done ranting – back to puppies and kitties)

  12. Posting again – but this is too funny – how I feel most of the time:

    “I really can’t frame my own response to this vile legislation any better than fellow Tennessee blogger Aunt B already did, so I’ll just quote her here:”

    I’m totally stealing that next chance I get :)

  13. 1. Ick.
    2. I have a frozen placenta that I will happily cut into itty pieces and ship unrefrigerated to every clown who’s involved in this, on your say-so. Ought to be pretty high by the time it arrives, if it goes parcel post. But wait, I guess there’s some law about body parts in the mail. Ne’er mind.
    3. I will point out that alcohol leaves the system pretty quickly, so if you drowned your miscarriage sorrows in booze, you’d be clear as soon as you sobered up. Anything else, though, and you’re SOL.
    4. Mandatory drug testing skeeves the heck out of me. Mandatory anything done to pregnant women (or women at all, but pregnant women in particular seem to come stamped “Property of the State”) skeeves me. As much as I am for reducing infant mortality, I can’t see how this is the way.

  14. Pingback: Being Amber Rhea » Blog Archive » links for 2009-02-20

  15. Pingback: The Letter I Sent to Senator Marrero « Tiny Cat Pants

  16. Your post very accurately describes many of the imperfections of this bill, and I agree with you on many points. The enormously high premature birth rate and infant mortality rate in Memphis and other parts of Tennessee are truly unfortunate; an infant dies in Shelby County every 43 hours. Steps must be taken to stem this tragedy. However, I agree with you in that this bill unfairly places the “blame solely on mothers” and takes away a woman’s right to control their body. I am a researcher that has studied the causes of conditions such as pre-term birth and intrauterine growth restriction. Premature birth and miscarriage cannot be attributed to any singular reason-it is a complex interplay of factors such as environment, mental state of the mother, infection, and genetics. It is unfortunate that the writers of this bill fail to understand the complexity of these conditions and instead assume that all women who show such symptoms are guilty of drug use. The state does not and should not have a right to test you for drugs without probable cause; and simply presenting with symptoms of miscarriage is not a just cause. Moreover, I agree that this bill would discourage many from seeking perinatal care at all. This law only tends to punish women; it does not actually solve the problem. Doctors are most effective in providing healthcare when they are viewed as allies working in the patient’s best interest. It is not their job to police expectant mothers. This bill proposes a huge invasion of privacy and I hope that it does not pass.

    I was a bit curious as to whether you think that this bill unfairly targets women of a certain socioeconomic status or race. I feel that the writers of this bill assume that drug users, many of whom are poor and black, are the only contributors to the high infant mortality rate. I find it appalling that other demographics and systemic factors that contribute to the problem have been completely ignored. Also, what do you think would be the best way to reduce infant mortality in that state? Obviously, the proposed bill is flawed and greatly reduces the right of women. But is there any other way?

  17. Hi, Avish Arora, thanks for coming by. There are a lot of different types of poor women in Tennessee who are constantly being accused of not acting right–from poor black women in Memphis to poor white women up in the mountains. So, I think that, in theory, this bill is supposed to unduly burden and police the behavior of all poor women (though the Senator who sponsored the bill is now saying that her intentions were misunderstood by the person who actually wrote it… I don’t know if I believe that or not).

    But in Tennessee, when people talk about Memphis, sometimes they’re just talking about the city, and sometimes they’re using it as a shortcut to talk about poor black people. So, I think it’s very right to be suspicious that, whenever people in Tennessee start talking about what we can do to fix Memphis, some people mean “what can we do to regulate the lives of poor black people.”

    I think, sadly, that there will always be some level of infant mortality. We have an obligation to make it as low as possible, but, as you know, sometimes things don’t work out, for reasons we don’t understand (or, even when we do understand them, we can’t fix).

    But I think we could make tremendous progress lowering our infant mortality rate in this state through some real concrete steps.

    1. We have to stop trying to pass legislation restricting sex ed. Abstinence-only might be a fine goal (I don’t think it is, but I’m prepared to accept that I’m in the minority), but girls and women need real, unbiased information about how our bodies work and what we can do to prevent pregnancies in the first place. In addition to that, we also need real, unbiased information about what’s happening during pregnancy and how to achieve the best outcome if we take the pregnancy to term.

    It’s heartbreaking to hear women talk about how they had no idea about the importance of vitamins or that breast-feeding their babies is good, if they can do it.

    I mean, we’re talking about a total failure in our state to provide women with that kind of basic information about how our bodies work and what they need to work properly.

    And then we turn around and blame women for not going to the doctor or for being fat, after we’ve severely limited the amount of knowledge about ourselves we’re allowed to have.

    Nobody’s personal discomfort with talking about human reproduction should trump a woman’s right to learn about how her body works.

    2. We have to support community-based programs that empower women to take control of our pregnancies and get the healthcare we need.

    In some cases, I believe that this is going to mean reconsidering a healthcare delivery system in which the patients come to the doctors and may mean that doctors go to the patients.

    But it also means supporting and funding projects like MIHOW and Healthy Start.

    3. We have to change the masculine culture of our communities. A lot of the mothers who lose children are children themselves. But the fathers of those dead babies aren’t 12, 13, or 14. We need to make it clear that having sex with children is gross and disgusting.

    We also have to address the violence in our communities. A woman who loses a child to a genetic abnormality is living through a tragedy that we, as a community, might not be able to do much about. But a woman who loses a child because her husband pulls her down the stairs? That was a preventable death. A woman who loses her child due to the stress of living in a neighborhood overrun by street gangs has lost her child unnecessarily.

    And, um, ha, well, sadly, I’m not sure what else. Obviously folks need access to good healthcare, but I’m not convinced that’s the sole solution.

  18. Pingback: Proposed Tennessee Bill Would Subject Poor Women to Mandatory Drug Tests

  19. Pingback: Proposed Tennessee Bill Would Subject Poor Women to Mandatory Drug Tests « DC: Freedom & Linux

  20. The following is the text of an amendment that will make HB2136. This bill is being proposed and will replace HB-890. It reflects what was originally intent ed for HB-890 to do. Unfortunately, it got off to a bad start due to poor communications with our staff attorney. Senator Marero and I have put HB2136 on notice for next week. It is my hope your readers will review it and send me their comments.
    Thanks
    Jim Hackworth
    HB2136 (v5 modified 04.02.09)

    AN ACT to amend Tennessee Code Annotated, Title 37,
    Chapter 5 and Title 68, relative to newborn infants.
    BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
    SECTION 1. Tennessee Code Annotated, Title 68, Chapter 5, is amended by adding
    Sections 2 through 3 as a new part thereto.

    SECTION 2. The purpose of this bill is to decrease the exposure of children to alcohol and drugs prior to birth and to avoid adverse consequences of any exposures that do occur by:
    (a) Improving access of pregnant women who abuse alcohol or drugs to effective treatment,
    (b) Ensuring that children who were exposed receive appropriate treatment and follow up,
    (c) Using supportive, non-punitive, and confidential approaches to promote the mother’s ability to care for her child, and
    (d) Ascertaining the extent of the problem of prenatal alcohol and drug exposure in Tennessee.

    SECTION 3.
    (a) The bureau of TennCare and the Department of Health shall work with health care providers to enhance opportunities for women who are pregnant to receive treatment for addiction to alcohol or controlled substances. The bureau of TennCare, the Department of Mental Health and Developmental Disabilities, the Department of Children’s Services and the Department of Health shall all work together to ensure that women who are addicted to alcohol or drugs and who have recently given birth will be referred to the appropriate agencies for any necessary services for themselves and their baby.
    (b) (1) If a health care provider has reason to believe based on a medical assessment of the mother or an infant that the mother used alcohol or a controlled substance for a nonmedical purpose during the pregnancy and that the infant is suffering from withdrawal from neonatal abstinence syndrome, such health care provider shall comply with the clinical standard of care in deciding whether to administer a confirmatory test, what treatment is needed, and what medical follow up is appropriate.
    (b)(2) A health care provider who determines, pursuant to this part, that a newborn infant is suffering from neonatal abstinence syndrome shall notify the department of children’s services. The department shall assess such child to ensure the child is getting adequate and appropriate services for any issues arising from the child’s mother’s abuse of alcohol or controlled substances. The department shall presume that the child should remain with the mother and so shall not intervene to disrupt this relationship in the absence of evidence of actionable abuse or neglect beyond the mother’s use of alcohol or drugs. The Department’s fundamental assumption shall be that most children are better off with their own families than in substitute care and that separation has detrimental effects on both parents and children. Whenever possible, preservation of the family should serve as the framework for services, but in any case, the best interest of the child shall be paramount.

    (b)(3) A health care provider who makes a report of alcohol or drug abuse as required by subsection (b)(2) shall not be liable in any civil or criminal action that is based solely upon such report.
    (c) All hospitals and birthing centers shall report to the Department of Health the number of infants born in their facility who were exposed to alcohol or drugs prenatally.
    (d)(1) All information, interviews, reports, statements, memoranda and drug or alcohol test results, written or otherwise, received through a drug or alcohol testing program are confidential communications and may not be used or received in evidence, obtained in discovery or disclosed in any public or private proceedings, except in accordance with this section.
    (d)(2) Information on drug or alcohol test results for tests administered pursuant to this part shall not be released or used in any criminal proceeding against the mother of the child who was subject to the test. Information released contrary to this section is inadmissible as evidence in a criminal proceeding.
    (d)(3) Laboratories, medical review officers, employee assistance programs, drug or alcohol rehabilitation programs and their agents who receive or have access to information concerning drug or alcohol test results shall keep all information confidential. Release of the information under any other circumstance is authorized solely pursuant to a written consent form signed voluntarily by the parent of the infant who is tested, unless the release is compelled by a hearing officer or a court of competent jurisdiction pursuant to an appeal taken under this section. The consent form must contain, at a minimum:
    (1) The name of the person who is authorized to obtain the information;
    (2) The purpose of the disclosure;
    (3) The precise information to be disclosed;
    (4) The duration of the consent; and
    (5) The signature of the person authorizing release of the information.
    (e) Prior to acting on the proposed rules to implement this chapter, the commissioner shall submit the proposed rules to the health and human resources committee of the House of Representatives and the senate general welfare health and human resources committee for their review and comment. The committees shall have forty-five (45) days to review the proposed rules and transmit any comment it may have to the commissioner.

    SECTION 4. For the purpose of promulgating rules and regulations, this act shall take effect upon becoming a law, the public welfare requiring it. For all other purposes this act shall take effect January 1, 2010, the public welfare requiring it.

  21. Hi, Representative Hackworth. Thanks for stopping by. I’m going to leave it to some of my more medically-astute readers to comment in detail, but I have some concerns.

    According to this article about neonatal abstinence syndrome, all kinds of substances, legal and not, can cause it, everything from cocaine to caffeine from barbiturates to anti-depressants.

    I’m sure that you’re aware that, during the height of the crack epidemic, we were repeatedly warned that women doing crack while pregnant would have, basically, monster children–that women doing drugs while pregnant was so bad that it ruined children for life. And that turned out to not be the case.

    Looking through the materials I can find about neonatal abstinence syndrome, I have that same suspicion.

    Don’t get me wrong. I’m not so naive as to try to claim that it doesn’t harm fetuses to be exposed to toxins. But I’m concerned about the State stepping into what seems to be a medical problem and a social problem.

    And I’m afraid of what will happen on the ground when this law is passed. Will a woman who is on anti-depressants who has a baby who exhibits signs of this syndrome be subjected to the intervention of DHS?

    I don’t know. Even from reading the materials I can find about Neonatal Abstinence Syndrome it sounds like there’s no consensus about what it is or how to determine if a child is suffering from it. It seems like “everyone knows that doing drugs is bad for pregnant women” and so people are trying to codify common knowledge into fact.

    There’s a danger there and I would hope we’re proceed with caution.

  22. Aunt B
    The bill as drafted guarntees that women asking for help will be directed to the proper care giver for help. No state dept will provide anything other than assistance for receiving the care. Th bill, in fact, gurntees that the woman seeking help can not be arrested or charged with any crime by coming in for help for her and her child. With regards to what causes harm to the fetus, two Vanderbilt Doctors have helped me to place the proper wording based on the most research supported by science into this legislation.
    I will be glad to ask them to call you if you wish regarding this matter.
    Jim

  23. My concern (and I realize that this is a concern the bill can’t reasonably address) is that there’s not too much point directing these women to the proper caregivers if the caregivers are already overextended and underfunded. I understand that it’s almost impossible to get into a state drug treatment/rehab program these days. If we really cared for those kids (which is the point of the bill, right?), we’d be willing to pay a bit more in taxes to help their mothers get right.

  24. Sorry, I also meant to say that as a participant in this discussion I appreciate the sponsors letting us know about this.

  25. Thank you for engaging in dialogue with TN women’s health advocates. As a social scientist, I am heartened to see that data collection is one aim of the bill. (Privacy concerns, as always, apply to all such aggregations of confidential data.) However, I see nothing in the bill that speaks to what exact data will be collected (which would clarify the assumptions driving the research), how the data collected will be interpreted, who will be doing the interpretation, how the results will be reviewed by external research personnel, or how the results of that research will be disseminated to the public and the public health community.

    If our future public policy is to be data-led on this issue, it’s imperative that we make some sensible decisions about what kind of questions get asked of clients to generate useful data and be clear about who has the expertise to handle the data in a confidential, scientifically sound and non-partisan way It would also be helpful to be as explicit as possible about the public health returns expected from this state-financed program.

  26. Hospitals already provide a significant amount of data. It is my hope we will gather data that will help us know how many of these children are being born. I would also think we should want ot know to the best of their ability the actual causes. It is my hope that the hospitals and doctors will help us know what data to collect. Regarding funding, many woman do not realize they can get help from Coverkids for them and the child during the pregnancy. The bill requires the State agencies to refer the Mothers for coverage.
    Jim

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