Americans need to engage in a "strong national debate about the most devastating and fastest-growing form of child abuse, prenatal abuse," according to the chief of the Children's Bureau and commissioner of the Administration for Children, Youth and Families in the Department of Health and Human Services.
"If you had a 6-month-old child and took a hammer and damaged the child's brain, we would first immediately remove the child from the home to protect him," said Wade Horn, who was in Salt Lake City for the Eighth Annual Conference on Child Abuse and Neglect. "With prenatal abuse through use of substances like alcohol and crack, you can't separate the child from the abuser - and we have to decide how we can protect the child."This is abuse that's going to be a 70-year sentence for the victim. My mission is to try to deliver childhoods to children. Too many kids are being robbed of that from the very minute of birth. Or before birth."
Mothers who accept treatment for their substance abuse don't present such a dilemma. But most parents in the throes of a strong addiction refuse treatment, he said.
Crack cocaine is certainly the worst offender, according to Horn. A small but growing problem in Utah, the drug is rampant in most of the United States. It is cheap and so addicting that "people are hooked the first time they use it. And its pull is so strong that when people become addicted, they lose all sense of everything except their next dose."
Maternal instinct dies completely. Horn told of a woman who offered to sell her child for $3 (the amount she needed to buy crack). When the prospective "buyer" refused, she demanded $3 or said she would kill the child.
Solving prenatal abuse is difficult. "We have to explore involuntary confinement" for pregnant women who refuse treatment, said Horn, a child psychologist who for years has treated abused children and their families. "We can confine people who are definitely a danger to themselves or others, and these women certainly are. But we must get into prevention, which is a lot cheaper in the long run. Otherwise, we'll be paying for 70 years of social services to these children."
Crack babies, in particular, interact differently than other children - even other addicted children. They are more detached. They play mechanically. And as they grow up, they are unable to attach and relate to others. If we don't do something about crack before addictions occur, "we will have to put triple and quadruple locks on our doors," Horn said.
The issues surrounding prenatal child abuse prevention are complex and distressing and some of them tie directly into abortion issues.
Abortion is generally available in the first trimester of pregnancy and is not illegal. Most prenatal damage is done in the first trimester as well - when most women, particularly addicted women, may not know they are pregnant. If abortion is legal but prenatal abuse isn't, Horn said, "It becomes somewhat illogical to say in effect that: You can't damage the child but you can kill it.
We are doing better as a nation in reducing drug abuse, but use of "hardcore drugs" has gone up while overall use has gone down. Prevention means keeping youth away from gateway drugs like alcohol, tobacco and marijuana.
"The answer is prevention. Once kids are into gangs or drugs, forget it. We must get to our children young and develop things for them to do in the community. We have to strengthen families. Once kids are in gangs and drugs, they are lost souls."