Ferguson v. City of Charleston Redux: Motivated Reasoning and Coercive Interventions in Pregnancy
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Ferguson v. City of Charleston Redux:
Motivated Reasoning and Coercive
Interventions in Pregnancy
Mary Faith Marshall, PhD,a Julia Taylor, MD, MA,a Debra DeBruin, PhDb
abstract Criminalization of perinatal substance use disorder and other coercive interventions in
pregnancy (such as forced cesarean delivery or involuntary hospitalization for bed rest)
directly affect the well-being of children and their families and, potentially, of all women of
reproductive capacity. Untenable legal and policy approaches that occasion such incursions
not only persist but affect a growing number of women. They are antithetical to healthy
pregnancies, healthy children, and healthy families; they have the potential to reduce prenatal
care seeking, divert attention and resources away from critical mental health and maternal
and child support services, and epigenetically affect maternal and infant bonding. Punitive and
coercive interventions contravene long-established guidance by professional associations that
advocate for public health approaches and ethical frameworks to guide practice. Harmful
policies persist because of motivated reasoning by clinicians, members of the judiciary, and ill-
informed legislators who rely on personal experience and anecdote rather than evidence to
fashion policy. Compounding the problem are inadequate substance use treatment resources
and professional associations that choose not to hold their members accountable for violating
their ethical obligations to their patients. Pediatricians must advocate for the cessation of
coercive interventions within their institutions and their larger communities. All health care
professionals should collaborate at the local, state, and national level to provide policymakers
and legislators with data emphasizing the negative effects of punitive and coercive policies
aimed at pregnant women and their children.
a
Center for Health Humanities and Ethics, University of Virginia, Charlottesville, Virginia; and bCenter for Bioethics, University of Minnesota, Minneapolis, Minnesota
Dr Marshall conceptualized and drafted the initial manuscript and revised the manuscript; Dr Taylor drafted portions of the manuscript and reviewed and
revised the manuscript; Dr DeBruin drafted portions of the manuscript and reviewed and revised the manuscript; and all authors approved the final
manuscript as submitted and agree to be accountable for all aspects of the work.
DOI: https://doi.org/10.1542/peds.2020-0818Q
Address correspondence to Mary Faith Marshall, PhD, Center for Health, Humanities and Ethics, Collins Building, PO Box 800758, Charlottesville, VA 22908.
E-mail: mfm@virginia.edu
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2020 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
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SUPPLEMENT ARTICLE PEDIATRICS Volume 146, number s1, August 2020:e20200818QAfter the Seattle conference, Defining of these interventions, including forced interventions in pregnancy in
Moments in Pediatric Bioethics: Future exacerbating race- and class-based 44 states, the District of Columbia,
Insights from Past Controversies, disparities, discouraging access to and federal jurisdictions between
some participants asked what prenatal care, and negative effects on 1973 and 2005. This is likely an
a presentation on coercive child and family health. Finally, we underestimate because barriers to
interventions in pregnancy had to do will highlight treatment needs and identifying cases undermine an
with pediatric ethics. Why review recommendations to address this accurate count.5 Coercive
a 26-year-old case, Ferguson v The problem. interventions include forced cesarean
City of Charleston et al,1 about deliveries, bed rest, and arrests and
criminalization of perinatal substance incarceration for behaviors allegedly
THE LANDSCAPE OF COERCIVE
use disorder (SUD) or other cases of INTERVENTIONS ON PREGNANT WOMEN exposing fetuses to risk, including
coercive interventions in pregnancy? IN THE NAME OF CHILD HEALTH suicide attempts, use of misoprostol
The answer: because they affect the to terminate pregnancy, falling down
Between 1989 and 1994, 30 pregnant
well-being of children and their the stairs, and substance use during
or postpartum women were arrested
families and potentially all women of pregnancy.5–8
when they or their newborns tested
reproductive capacity.
positive for cocaine after warrantless Of the 413 cases identified in the
Untenable legal and policy searches at the Medical University of review by Paltrow and Flavin,5 84%
approaches occasioning coercive South Carolina, a public hospital. involved substance use. Rates of
interventions in pregnancy not only These patients “failed” treatment arrests and detentions for substance
persist but affect a growing number when they tested positive a second use in pregnancy are increasing. US
of women. They are antithetical to time or missed a prenatal visit. data from Amnesty International
healthy pregnancies, healthy children, Twenty-nine were African American. reveal that from 2005 to 2016,
and healthy families; they often “Boyfriend is a Negro” was written in chemical endangerment, fetal neglect,
reduce prenatal care seeking and the medical record of the patient who or fetal assault charges were brought
divert attention and resources away was not African American. Punitive against some 700 women in just 3
from mental health and maternal and measures included incarceration states (AL, TN, and SC); all involved
child support services. before and/or after childbirth, substance use.7 The phenomenon is
shackles and handcuffs during more widespread: Twenty-three
Coercive interventions contravene transport and hospitalization, and states and the District of Columbia
long-established professional removal of child custody for existing consider substance use during
guidance by the American Academy children. In Ferguson v The City of pregnancy to be child abuse under
of Pediatrics (AAP),2 American Charleston (1993), arrestees sued the civil child-welfare statutes; 3 consider
College of Obstetricians and Medical University, the Charleston it grounds for civil commitment.
Gynecologists (ACOG),3 American police department, and the local Twenty-five states and the District of
Academy of Family Practitioners,4 solicitor. The US Supreme Court Columbia require health care
and other professional associations (2000) found that the defendants’ professionals to report suspected
that advocate for public health actions violated the Fourth prenatal drug use, and 8 states
approaches and ethical frameworks Amendment’s proscription of illegal require testing for prenatal drug
to guide practice. Coercions persist, search and seizure. Amicus briefs in exposure if they suspect drug use.9
even when their harms are well support of the plaintiffs were filed,
documented, because of motivated among others, by the AAP, American Within this narrower category of
reasoning by clinicians, judges, and Medical Association, ACOG, American coercive interventions involving
ill-informed legislators. Inadequate Public Health Association, American substance use, cases vary
SUD treatment resources and Medical Women’s Association, significantly.
professional associations that fail to American Society for Addiction
hold their members accountable for ∙ Regina McKnight was convicted of
Medicine, National Council on
violating their ethical obligations homicide by child abuse when her
Alcoholism and Drug Dependence,
compound the problem. pregnancy ended in stillbirth.
National Association of Social
Authorities alleged that her cocaine
Workers, and the March of Dimes.
We begin with a brief background on use caused the stillbirth, although
coercive interventions in pregnancy, Since Ferguson, arrests and other they presented no credible data to
followed by a closer look at the incursions continue to accelerate. support that allegation; it was later
evidence underlying interventions Paltrow and Flavin,5 in their shown that infection caused the
aimed at women with known or comprehensive review, document stillbirth. After serving 8 years of
suspected SUD and the implications 413 cases of arrests, detentions, and her sentence, an appeals court
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PEDIATRICS Volume 146, number s1, August 2020 S87overturned her conviction on pregnant women to avoid prenatal future childbearing.” Beck,20 in
grounds that her counsel failed to care or hospital delivery.10,12–14 a metaethnography of qualitative
present relevant evidence for her However, “as with pregnant women in studies of traumatic birth, notes that
defense. However, fearing that she general, women who use drugs and women may experience as traumatic
would be retried and returned to receive adequate prenatal care births that clinicians view as routine
prison, she pleaded guilty to generally have better pregnancy and normal. She describes similar
manslaughter and was released outcomes than women who use drugs experiences to those highlighted by
given time served.5,10 and do not receive adequate care.”12 Forssén19: “Women felt abandoned,
∙ Casey Shehi tested positive for Increasing access to prenatal care in stripped of their dignity, and not
benzodiazepines during labor; she this population reduces risks (eg, of cared for as an individual who
had taken half a Valium on 2 prematurity, low birth weight, and deserved to be treated with
occasions late in pregnancy to small-for-gestational-age status), respect.”20 Beck20 notes that
manage acute distress. She although the rates of reduction vary traumatic birth experiences can
believed this would be safe, for specific risks across studies.15–17 negatively affect the women’s
because doctors had prescribed Because the threat of coercive relationships with their children as
painkillers earlier in her pregnancy. interventions deters access to well as maternal-fetal bonding in
No drugs were found in her prenatal care among women with subsequent pregnancies.
newborn and he was healthy. SUD, they also increase risks for Recent evidence indicates that “early
However, she was arrested and infants. In fact, the AAP recommends experience in maternal care predicts
“charged with ‘knowingly, not just obstetric prenatal care but epigenetic change within the infant
recklessly, or intentionally’ causing prenatal pediatric visits: “As the oxytocin system, levels of which are
her baby to be exposed to medical specialty that is entirely in turn reflective of infant
controlled substances in the womb focused on the health and well-being temperament.”21 This study
—a felony punishable by up to of the child embedded in the family, demonstrates the association
10 years in prison.” After posting pediatric care ideally begins before between the degree of the woman’s
bond she was released from jail but pregnancy, with reproductive life engagement with her child and
subjected to frequent drug tests planning of adolescents and young epigenetic changes in the oxytocin
while her case was pending trial. adults, and continues during the receptor gene. Child well-being is
After nearly a year, her case was pregnancy, with an expectant mother effected because:
dismissed.6 and father of any age.”18
Oxytocin is a crucial regulator of human
social behavior. Individual differences
Consequences for pregnant or within the oxytocin system—assessed
peripartum women who test positive COERCION AND TRAUMA: IMPACT ON through hormonal levels, epigenetic
for drugs or alcohol can include arrest CHILDREN modification, or genetic variation—
and incarceration, involuntary civil Whether a woman receives prenatal have been linked to differential
commitment for treatment or sensitivity to social cues, prosocial
care, the trauma associated with
behaviors, and stress responsiveness in
protective state custody, reporting to coercive interventions, or fears that adults.21
child protective services, and removal they may be imposed, may
of child custody. Policies on alcohol undermine the well-being of both the These findings raise significant
use during pregnancy are woman and her child. Even when concern about the secondary impact
increasingly retributive and coercive intervention is not involved, of maternal coercion on the child.
punitive.11 negative experiences during If the woman is incarcerated, while
childbirth, such as blaming and she is pregnant or after giving birth,
shaming women for behaviors effects on maternal-child bonding
DISCOURAGING ACCESS TO PRENATAL perceived to increase risk during may be more extreme. Owing in part
CARE pregnancy, can be experienced as to stiffer drug sentencing, the number
Roberts and Pies12 note, “Pregnant traumatic and strain connection of incarcerated women has increased
women who use drugs are over- with the child. In a series of eightfold since 1980.22 Incarcerated
represented among women who in-depth interviews with Swedish women have described being denied
receive late, limited, and no prenatal women, Forssén19 found that such labor support even when plans were
care.” Substance use is associated experiences were forcefully alienating in place to allow labor coaching from
with barriers to prenatal care.12 for many of them. Over decades, they a friend or relative. Labor support
Significantly, fears of prosecution for experienced “feelings of failure as from a person chosen by the woman
drug or alcohol use during pregnancy, mothers, of guilt, and of shame, that reduces anxiety and the perception of
or loss of child custody, may drive influenced their self-esteem and their pain. Incarcerated women may also
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S88 MARSHALL et albe shackled during labor23 despite (14.1%) women, the latter were whenever it’s one of those drugs. I
ACOG guidance against the practice.24 10 times more likely to be reported to mean, an opioid—that’s just such
a powerful drug.
One woman described her experience authorities. Subsequent studies have
with restraints: “The handcuffs made demonstrated the sequelae of
These policies occasion incursions
me feel inhumane. I don’t want to cry, persistent racism, discrimination,
against women’s liberty and bodily
but it made me feel like an animal. I power differentials, and stereotyping
integrity, and the potential for
think at that point, I understood that I on pregnant women.28–36
harmful consequences for them and
was not seen as a human being.”23 In
their children. Morality requires their
the absence of a dedicated program
THE ROLE OF EVIDENCE IN COERCION grounding in evidence.
to promote a humane birthing
experience to support maternal-child In their review, Paltrow and Flavin5 Why do some clinicians persist in
bonding, newborns are standardly document that coercive interventions violating their fiduciary relationships
separated from their mothers soon often lack grounding in evidence: by acceding to chemical
after birth. One mother declared: Although deprivations of women’s endangerment laws, pursuing judicial
“That was the most dramatic thing liberty are often justified as authorizations for forced treatment,
ever and traumatizing. And oh my mechanisms for protecting children and threatening to or notifying child
God, I was devastated, like there was from harm, we found that in a majority
protective services (with the
nothing. No amount of preparation or of cases the arrest or other action taken
was not dependent on evidence of attendant specter or reality of
before knowledge can prepare actual harm to the fetus or newborn… removal of child custody)? Why do
somebody for that.”23 In many cases criminal charges rested they, with impunity, flaunt practice
on the claim that there was a risk of and ethics norms from their
Although the intended purpose of harm or a positive drug test but no
professional associations? Why do
coercion is to protect infants, in actual evidence of harm. Similarly, in
numerous cases where court orders trial courts ignore established legal
reality it harms both women and their
were sought to force medical precedent? And why do legislators
children.
interventions, a risk of harm was pass laws that flout the collective
identified that did not materialize. In guidance of professional
cases where a harm was alleged (e.g.,
organizations?
RACE AND CLASS-BASED DISPARITIES a stillbirth), we found numerous
instances in which cases proceeded
Risks associated with coercive without any evidence, much less The legislator’s responses above
interventions fall disproportionately scientific evidence, establishing a causal provide two answers: ignorance of
on particular groups of women. link between the harm and the the facts and willful ignorance. Their
Paltrow and Flavin5 document pregnant woman’s alleged action or comments exemplify the
socioeconomic and racial disparities, inaction.5 psychological phenomenon of
with 71% of women qualifying for In a recent study of legislators in motivated reasoning, which occurs
indigent defense and 59% of cases Maryland, Virginia, and North when someone selectively interprets
involving women of color, mostly Carolina, researchers found that evidence depending on whether it
African American women. Studies personal experience, anecdotes, and comports with their preconceived
have also found racial bias in known contacts rather than evidence beliefs.38 The standard for evidence
maternal and newborn drug influenced policy development that that supports these beliefs is “Can I
screening.25,26 These disparities have prioritized interventions that believe this?” The person then
persisted over time. A 1990 New York targeted opioids over those targeting selectively embraces data that
Times article lamented: “Charges of alcohol use in pregnancy.37 endorses the belief. “Must I believe
‘prenatal crime’ used to occur about Legislators made the following this?” is the standard for
twice a decade: since 1987 there have observations: contradictory evidence, followed by
been more than 50 such prosecutions. a concomitant search for evidence
I think opiate use [during pregnancy]
The overwhelming majority of the has probably got a bigger impact [than allowing the offending data to be
defendants (∼70%) are poor and alcohol use], to be honest with you. I disregarded.39 Thus, the social
black…the discriminatory mean, opioid use is pretty rampant, way intuitionist field of moral psychology
enforcement is a result of more than alcohol. (known as moral foundations theory)
a combination of racism and the Alcohol vs drugs…it’s comparing holds that moral intuitions (moral
mother’s poverty.”27 Also in 1990, apples and oranges to see the effects on emotions) occur before moral
Chasnoff et al26 reported that the child when it’s born. Whether it be reasoning (ie, moral justifications are
what they call crack babies, meth
although rates of substance use in babies, opioid-addicted babies—I don’t post hoc and are based on intuitive
pregnancy are similar in White think that the effect of alcohol on that judgments).40–42 The process is
(15.4%) and African American child when it’s born is as great as it is described as “the tail wagged by the
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PEDIATRICS Volume 146, number s1, August 2020 S89intuitive dog,”43 “sleight of mind,”44 create barriers to adequate prenatal
and “an illusion of objectivity.”45 care and fail to direct resources
ABBREVIATIONS
toward interventions promoting AAP: American Academy of
maternal and child health. The Pediatrics
TREATMENT NEEDS
argument that the health of the child ACOG: American College of Obste-
The harmful effects of coercive warrants coercive approaches fails to tricians and Gynecologists
interventions are compounded by recognize adverse consequences on SUD: substance use disorder
a lack of treatment resources for the pregnant woman and her child. In
SUD.46–49 In an article on the unmet addition to the harms affecting
needs for SUD treatment among individuals, we must acknowledge the REFERENCES
reproductive age women, authors injustices in the disparate application
showed that50: 1. Ferguson v City of Charleston et al, 532
of coercive interventions across race U.S. 67 (2001).
∙ nine percent of reproductive-age and class. It is especially alarming
2. Patrick SW, Schiff DM; Committee on
women needed SUD treatment; that the imposition of coercion in
Substance Use and Prevention. A public
∙ most women who needed SUD particular cases, and the development health response to opioid use in
treatment did so for alcohol use of policies permitting such pregnancy. Pediatrics. 2017;139(3):
disorder; interventions, often fail to reflect e20164070
evidence. We therefore make the
∙ ,10% of them received it; 3. American College of Obstetricians and
following recommendations: Gynecologists Committee on Ethics.
∙ pregnant women were not more
1. ACOG’s Code of Professional Ethics Committee Opinion No. 633. Alcohol
likely to receive needed SUD
allows the organization to abuse and other SUDs: ethical issues in
treatment; and
withhold or withdraw Fellowship obstetric and gynecologic practice.
∙ Black and Hispanic women were 2015 (Reaffirmed 2018). Obstet Gynecol.
from those who violate it.53 ACOG
less likely to receive treatment. 2015;124:1529–1537
has not sanctioned members who
In a recent study on motivators coerce their patients with 4. American Academy of Family
and barriers to SUD treatment of involuntary commitment, Physicians. Position Paper:
pregnant women, researchers found treatment over refusal, and Preconception Care. Leawood, KS:
that motivators were readiness to American Academy of Family
threatened or actual judicial
Physicians; 2015. Available at: www.
stop using, concern for the infant’s intervention. Perhaps if ACOG
aafp.org/about/policies/all/
health, concern about custody of were to begin using this tool to preconception-care.html. Accessed
the infant or other children, enforce its code of ethics, some November 11, 2019
wanting to escape violent progress could be made toward
5. Paltrow LM, Flavin J. Arrests of and
environments or homelessness, reducing the harms of coercion.
forced interventions on pregnant
and seeking structure. Barriers 2. AAP has embraced a public health women in the United States, 1973–2005:
were fear of loss of custody, not approach to substance use during implications for women’s legal status
wanting to be away from children or pregnancy as optimal for the and public health. J Health Polit Policy
partner, concern about stigma or health of women and children. Law. 2013;38(2):299–343
privacy, and lack of child care and Pediatricians must advocate for 6. Martin N. Take a valium, lose your kid,
transportation.51 Additional barriers the cessation of coercive go to jail. ProPublica. September 23,
identified by Johnson include interventions within their 2015. Available at: https://www.
unstable financial situations, drug- institutions and their larger propublica.org/article/when-the-womb-
seeking or functional impairment communities as a matter of utmost is-a-crime-scene. Accessed September
from drug use, and fear of child importance for child and family 16, 2019
protective services.52 White women welfare. 7. Amnesty International. Criminalizing
are more likely to receive treatment, pregnancy: policing pregnant women
whereas African American women are 3. To combat willful ignorance and
who use drugs in the USA. Report. 2017.
more likely to be referred to child motivated reasoning, all health Available at: https://www.amnesty.org/
protective services, even in programs care professionals should download/Documents/
of universal screening for drug use.48 collaborate at the local, state, and AMR5162032017ENGLISH.pdf. Accessed
national level to provide September 16, 2019
policymakers and legislators with 8. Paltrow LM, Sangoi LK. The dangerous
CONCLUSIONS data emphasizing the negative state laws that are punishing pregnant
Current coercive policies directed at effects of punitive and coercive people. Think Progress. September 28,
women with known (or suspected) policies aimed at pregnant women 2016. Available at: https://
substance use during pregnancy and their children. thinkprogress.org/criminalization-
Downloaded from www.aappublications.org/news by guest on October 24, 2021
S90 MARSHALL et alpregnancy-us-43e4741bb514/. Accessed elderly Swedish women. Qual Health adverse birth outcomes: an integrative
September 16, 2019 Res. 2012;22(11):1535–1546 review. J Midwifery Womens Health.
20. Beck CT. A metaethnography of 2016;61(6):707–720
9. Guttmacher Institute. Substance use
during pregnancy. 2019. Available at: traumatic childbirth and its aftermath: 30. Bower KM, Geller RJ, Perrin NA, Alhusen
https://www.guttmacher.org/state- amplifying causal looping. Qual Health J. Experiences of racism and preterm
policy/explore/substance-use-during- Res. 2011;21(3):301–311 birth: findings from a pregnancy risk
pregnancy. Accessed November 6, 2019 21. Krol KM, Moulder RG, Lillard TS, assessment monitoring system, 2004
Grossmann T, Connelly JJ. Epigenetic through 2012. Womens Health Issues.
10. Stone R. Pregnant women and
dynamics in infancy and the impact of 2018;28(6):495–501
substance use: fear, stigma, and
barriers to care. Health Justice. 2015;3: maternal engagement. Sci Adv. 2019; 31. Mehra R, Boyd LM, Ickovics JR. Racial
2 5(10):eaay0680 residential segregation and adverse
22. The Sentencing Project. Incarcerated birth outcomes: a systematic review
11. Roberts SCM, Mericle AA, Subbaraman
women and girls. 2019. Available at: and meta-analysis. Soc Sci Med. 2017;
MS, et al. Differential effects of
https://www.sentencingproject.org/ 191:237–250
pregnancy-specific alcohol policies on
drinking among pregnant women by publications/incarcerated-women-and- 32. Nuru-Jeter A, Dominguez TP, Hammond
race/ethnicity. Health Equity. 2018;2(1): girls/. Accessed November 12, 2019 WP, et al. “It’s the skin you’re in”:
356–365 23. Fritz S, Whiteacre K. Prison nurseries: African-American women talk about
experiences of incarcerated women their experiences of racism. an
12. Roberts SCM, Pies C. Complex exploratory study to develop measures
calculations: how drug use during during pregnancy. J Offender Rehabil.
2016;55(1):1–20 of racism for birth outcome studies.
pregnancy becomes a barrier to Matern Child Health J. 2009;13(1):29–39
prenatal care. Matern Child Health J. 24. American College of Obstetricians and
2011;15(3):333–341 Gynecologists Committee on Healthcare 33. Slaughter-Acey JC, Caldwell CH, Misra
for Underserved Women. Healthcare for DP. The influence of personal and group
13. American Civil Liberties Union. Coercive racism on entry into prenatal care
and punitive governmental responses pregnant and postpartum incarcerated
women and adolescent females. among African American women.
to women’s conduct during pregnancy. Womens Health Issues. 2013;23(6):
2018. Available at: https://www.aclu. Committee Opinion 511. November 2011
(Reaffirmed 2019). Available at: https:// e381–e387
org/other/coercive-and-punitive-
governmental-responses-womens- www.acog.org/clinical/clinical- 34. Calabrese SK, Earnshaw VA, Underhill K,
conduct-during-pregnancy. Accessed guidance/committee-opinion/articles/ Hansen NB, Dovidio JF. The impact of
November 9, 2019 2011/11/health-care-for-pregnant-and- patient race on clinical decisions
postpartum-incarcerated-women-and- related to prescribing HIV pre-exposure
14. Jos PH, Marshall MF, Perlmutter M. The adolescent-females. Accessed prophylaxis (PrEP): assumptions about
Charleston policy on cocaine use November 12, 2019 sexual risk compensation and
during pregnancy: a cautionary tale. implications for access. AIDS Behav.
J Law Med Ethics. 1995;23(2):120–128 25. Kerker BD, Horwitz SM, Leventhal JM.
Patients’ characteristics and providers’ 2014;18(2):226–240
15. El-Mohandes A, Herman AA, Nabil El- attitudes: predictors of screening 35. Rosenthal L, Lobel M. Stereotypes of
Khorazaty M, Katta PS, White D, Grylack pregnant women for illicit substance black American women related to
L. Prenatal care reduces the impact of use. Child Abuse Negl. 2004;28(2): sexuality and motherhood. Psychol
illicit drug use on perinatal outcomes. 209–223 Women Q. 2016;40(3):414–427
J Perinatol. 2003;23(5):354–360
26. Chasnoff IJ, Landress HJ, Barrett ME. 36. Shavers VL, Fagan P, Jones D, et al. The
16. Berenson AB, Wilkinson GS, Lopez LA. The prevalence of illicit-drug or alcohol state of research on racial/ethnic
Effects of prenatal care on neonates use during pregnancy and discrimination in the receipt of health
born to drug-using women. Subst Use discrepancies in mandatory reporting care. Am J Public Health. 2012;102(5):
Misuse. 1996;31(8):1063–1076 in Pinellas County, Florida. N Engl 953–966
17. MacGregor SN, Keith LG, Bachicha JA, J Med. 1990;322(17):1202–1206 37. Woodruff K, Roberts SCM. “Alcohol
Chasnoff IJ. Cocaine abuse during 27. Roberts D. The bias in drug arrests of during pregnancy? Nobody does that
pregnancy: correlation between pregnant women. The New York Times anymore”: state legislators’ use of
prenatal care and perinatal outcome. August 11, 1990:A25 evidence in making policy on alcohol
Obstet Gynecol. 1989;74(6):882–885 use in pregnancy. J Stud Alcohol Drugs.
28. Altman MR, Oseguera T, McLemore MR,
18. Yogman M, Lavin A, Cohen G; Committee Kantrowitz-Gordon I, Franck LS, Lyndon 2019;80(3):380–388
on Psychosocial Aspects of Child and A. Information and power: women of 38. Kunda Z. The case for motivated
Family Health. The prenatal visit. color’s experiences interacting with reasoning. Psychol Bull. 1990;108(3):
Pediatrics. 2019;142(1):e20181218 health care providers in pregnancy and 480–498
19. Forssén ASK. Lifelong significance of birth. Soc Sci Med. 2019;238:112491 39. Minkoff H, Marshall MF. Fetal risks,
disempowering experiences in prenatal 29. Alhusen JL, Bower KM, Epstein E, relative risks, and relatives’ risks. Am
and maternity care: interviews with Sharps P. Racial discrimination and J Bioeth. 2016;16(2):3–11
Downloaded from www.aappublications.org/news by guest on October 24, 2021
PEDIATRICS Volume 146, number s1, August 2020 S9140. Haidt J, Joseph C. Intuitive ethics: how inference: a biased hypothesis-testing 49. Gorman A. Barriers remain despite
innately prepared intuitions generate model. Adv Exp Soc Psychol. 1987;20: health law’s push to expand access to
culturally variable virtues. Daedalus. 297–340 substance abuse treatment. Kaiser
2004;133(4):55–66 Health News. April 10, 2014. Available at:
46. Bondurant SR, Lindo JM, Swensen ID.
41. Haidt J, Joseph C. The moral mind: how https://khn.org/news/substance-abuse-
Access to substance abuse treatment,
five sets of innate moral intuitions drug overdose deaths, and crime.
treatment-access-health-law/. Accessed
guide the development of many culture September 16, 2019
EconoFact. March 26, 2018. Available at:
specific virtues, and perhaps even 50. Martin CE, Scialli A, Terplan M.
http://econofact.org/access-to-
modules. In: Carruthers P, Laurence S, Unmet substance use disorder
substance-abuse-treatment-drug-
Sich S, eds. The Innate Mind, Vol 3. New treatment need among reproductive
overdose-deaths-and-crime. Accessed
York, NY: Oxford University Press; 2007:
September 16, 2019 age women. Drug Alcohol Depend. 2020;
367–391
206:107679
42. Haidt J, Graham J. When morality 47. Mental Health America. 2017 State of
opposes justice: conservatives have mental health in America - access to 51. Frazer Z, McConnell K, Jansson LM.
moral intuitions that liberals may not care data. 2017. Available at: https:// Treatment for substance use disorders
recognize. Soc Justice Res. 2007;20: www.mhanational.org/issues/2017- in pregnant women: motivators and
98–116 state-mental-health-america-access- barriers. Drug Alcohol Depend. 2019;
care-data. Accessed September 16, 205
43. Haidt J. The Righteous Mind: Why Good
People Are Divided by Politics and 2019 52. Johnson E. Models of care for opioid
Religion. New York, NY: Pantheon Books, 48. Bishop D, Borkowski L, Couillard M, dependent pregnant women. Semin
Random House; 2012 Allina A, Baruch S, Wood S. Pregnant Perinatol. 2019;43(3):132–140
44. Ditto PH, Pizarro DA, Tannenbaum D. Women and Substance Use: Overview of 53. American College of Obstetricians and
Motivated moral reasoning. In: Bartels Research & Policy in the United States. Gynecologists. Code of professional
DM, Bauman SW, Skitka LJ, Medin DL, Jacobs Institute of Women’s Health. ethics. Available at: https://www.acog.
eds. The Psychology of Learning and Bridging the Divide Paper, 2017. org/-/media/project/acog/acogorg/
Motivation. San Diego, CA: Elsevier; Available at: https://publichealth.gwu.e files/pdfs/acog-policies/code-of-
2009:307–338 du/sites/default/files/downloads/JIWH/ professional-ethics-of-the-american-
45. Pyszczynski T, Greenberg J. Toward an Pregnant_Women_and_Substance_ college-of-obstetricians-and-
integration of cognitive and Use_updated.pdf. Accessed November gynecologists.pdf. Accessed September
motivational perspectives on social 11, 2019 15, 2019
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S92 MARSHALL et alFerguson v. City of Charleston Redux: Motivated Reasoning and Coercive
Interventions in Pregnancy
Mary Faith Marshall, Julia Taylor and Debra DeBruin
Pediatrics 2020;146;S86
DOI: 10.1542/peds.2020-0818Q
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Services http://pediatrics.aappublications.org/content/146/Supplement_1/S86
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Downloaded from www.aappublications.org/news by guest on October 24, 2021Ferguson v. City of Charleston Redux: Motivated Reasoning and Coercive
Interventions in Pregnancy
Mary Faith Marshall, Julia Taylor and Debra DeBruin
Pediatrics 2020;146;S86
DOI: 10.1542/peds.2020-0818Q
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/146/Supplement_1/S86
Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it
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