Since I don’t really feel like typing any significant fresh content today, I’m going to repost this blog entry from the original Blogspot OH. This post appeared April 19, 2015. It’s been retitled and edited somewhat, because there was dated and irrelevant content in the original post.

Last night, I shared this photo, which randomly popped up on my Facebook feed.  A woman I knew in school had posted it with the comment “You’ve been warned.  No excuses.” I knew the photo would generate discussion, and it did. Most of my friends were horrified by the photo, although “Papa Smurf” was a notable and predictable outlier. [Papa Smurf is a former friend now… he was a mansplaining pain in my ass one too many times, and I finally advised him to fuck off. I call him Papa Smurf because he was very sanctimonious and enjoyed trying to act like everybody’s daddy.]

I understand the idea behind this sign and I comprehend why a lot of people are behind its sentiment.  However, while I get why people agree with it, I think it’s counterproductive to threaten patients before they’ve even been seen.  All a sign like this does is tell the pregnant mom who might be using drugs that the doctor would prefer them to go somewhere else for their prenatal care.  Indeed, that could be why the sign was posted.  OB-GYNs typically pay a lot in malpractice insurance, and a pregnant person with drug issues could potentially have a riskier pregnancy.  Of course, a drug abusing mom who is really bad off probably wouldn’t bother with prenatal care anyway. 

Those who use drugs recreationally might see a doctor, but if the doctor flat out tells them they will call the law on them, they will very likely avoid medical care.  That may be fine and dandy for the doctor who doesn’t have to deal with them, but what about the unborn child?  The sign seems to be advocating for the welfare of the unborn baby, but if the doctor scares off the mother, what good does that do?  And doesn’t that sort of conflict with what doctors are supposed to be doing, which is providing healthcare to people who need it?

I happen to be pro-choice, but I couldn’t help but notice.  As long as abortion is legal in the United States [remember, this was written in 2015], it seems kind of ridiculous to take this sort of attitude, anyway.  I mean, the mother to be can terminate her pregnancy if she chooses.  Using illegal drugs is against the law, anyway.  Why turn it into a crime against the unborn?  Why does the fact that the mom to be is pregnant even come into it?  She’s breaking the law, so deal with her. 

At this point, we don’t force people to see their doctors.  People have a hard enough time accessing appropriate medical care for reasons other than being threatened and alienated.  This attitude of needing to police private citizens is creepy to me [I really had no idea what was coming, eight years ago, did I?], and in the long run, I don’t think it makes things better for anybody.  Of course a pregnant woman shouldn’t be using drugs, and something should be done if she comes up positive on a drug screen.  I think the attitude toward her should be more supportive and helpful, not threatening.    

Besides…  a woman whose newborn baby comes up positive on a drug screen at the hospital is going to be referred to CPS anyway.  All that sign does is encourage the mother to avoid seeing doctors and give birth outside of a medical setting.

Here’s another thought.  For most medical procedures, physicians must get informed consent before they go ahead with it.  I suppose a sign like this informs patients that the doctor(s) at this practice will do random drug screens, and gives them the option of going elsewhere for their prenatal care.  But what about health care professionals that do screenings without the patient’s knowledge or consent?  Isn’t that a violation of their rights?

I know there have been cases in which mothers have been arrested for having positive drug screens and have gone to court.  In South Carolina, there was a big case involving pregnant women, Ferguson v. City of Charleston, who were tested for drugs without their knowledge or consent.  It went all the way to the Supreme Court, which ruled that the search in question was unreasonable, especially since the searches had the potential to land someone in jail.

In any case, while I certainly wouldn’t condone a pregnant woman using drugs, and I agree something should be done to help or dissuade drug abuse in pregnant women, I don’t think taking an adversarial, threatening attitude is in the best interest of patients.  The goal shouldn’t be to sell mom down the river; it should be to get her appropriate help so she can successfully raise her child.  I think it would be hard to do that by threatening patients with getting the police and child protective services involved before they’ve even been seen.  

Edited to add in 2023: I don’t know if the photo is real or fake. I just thought the discussion it generated was interesting. You can see the original post here.