Misconceiving Mothers: Legislators, Prosecutors, and the Politics of Prenatal Drug Exposure.

• Author: Roberts, Dorothy E.
• Position: Review

MISCONCEIVING MOTHERS: LEGISLATORS, PROSECUTORS, AND THE POLITICS OF PRENATAL DRUG EXPOSURE. By Laura E. Gomez. Philadelphia: Temple Press. 1997. 207. $59.95

1. INTRODUCTION

   In the mid-1980s newspapers began to report an explosion of babies born affected by drugs in the womb(1) The crisis of drug-exposed babies cried out for action. Prosecutors across the county decided to tackle the problem by prosecuting the babies' mothers. Between 1985 and 1995, at least two hundred women in thirty states were charged with crimes arising from drug use while pregnant.(2) At the same time, state lawmakers seized upon the problem as a topic of legislation. In 1990, legislatures in thirty-four states debated bills concerning prenatal substance abuse.(3) In California alone, some twenty different bills relating to the problem of drug use during pregnancy were pending before the legislature at one time.(4) Within a decade, however, the frenzy to criminalize pregnant women abated. Women's advocates, public health organizations, and physicians successfully campaigned to redefine prenatal drug use as a health problem rather than a crime.

   Misconceiving Mothers: Legislators, Prosecutors, and The Politics of Prenatal Drug Exposure(5) is a fascinating study of the career of prenatal drug exposure as a social problem. Professor Laura Gomez tracks the life cycle of this issue from its initial "discovery" as a social problem arising from its alarming portrayal in the media and medical research to its institutionalization in state bureaucratic agencies as a public health concern. The responses of California state legislators and district attorneys provide a case study of how social problems are defined and solved. The book's sociological approach is a refreshing departure from the now-familiar legal analysis that frames the prosecution of prenatal crimes as a contest between maternal and fetal rights.

   Gomez discovers that the career of a social problem is a dynamic process: the interpretation of prenatal substance abuse changed dramatically as social actors competed for ownership of its meaning. In the course of its investigation of prenatal drug exposure, Misconceiving Mothers seeks to solve two mysteries. First, why did the California legislature reject measures to criminalize drug use during pregnancy despite the public's initial support for a punitive approach? Second, why did some California prosecutors pursue criminal charges when most of their counterparts did not? To answer these questions, Professor Gomez explores various dimensions of social life that determined the state's response to prenatal drug use. She examines the social understanding of this problem at various stages of its life cycle. She also focuses on the set of institutions that address the social problem and help to determine its meaning. Professor Gomez includes several institutions in her study: state legislators, prosecutors, judges, social agencies, advocacy organizations, and doctors. Finally, she recognizes that the construction of the social problem is governed by social norms. In this case, the norms of motherhood--influenced by race, class, and gender politics--were critical to the public's understanding of prenatal substance abuse. While these forces initially produced an alarming portrayal of the problem that called for criminal punishment, they ultimately transformed the problem into a public health concern best treated by social and medical services.

   This review essay discusses Gomez's analysis of the relationship among these social actors and forces that helped to define and solve the problem of prenatal drug exposure. The book's focus on the institutionalization of this problem within the California legislature and district attorneys' offices yields many important insights into the construction of social problems in general and the strategies that transformed the government's response to this particular issue. In Part II, I argue that the constructionist approach to social problems also suggests important alternative avenues for study. In addition to comparing the internal processes of state agencies, students of social problems should also examine the impact that the institutionalization process of key state agencies has on each other. The success of feminist activists and doctors in converting the problem from a crime to a public health issue also begs for further investigation. How did these groups mobilize so successfully and why were they far more influential in California than in South Carolina, where prosecutions for prenatal crimes continue? I also discuss how race and class, along with gender, shaped the social norms that contributed to the problem's career.

   Finally, the victory for feminists in defeating the punitive approach to maternal substance abuse also raises critical questions about strategies for furthering gender equality. Gomez attributes their success to their ability to disconnect prenatal drug exposure from poor women of color who were more likely to be criminalized, linking it instead to issues that affected all women. In Part III, I critique the strategy of universalizing women's problems as a means of unifying women and gaining popular support for their interests.

2. CREATING A SOCIAL PROBLEM

   Professor Gomez, who is trained as a sociologist, uses sociological theory to analyze prenatal substance abuse. Gomez adopts a constructionist approach to studying social problems. The constructionist approach "views social problems as the product of interactions among social actors, whether individuals, organizations, or institutions."(6) The constructionist approach can be compared with the objectivist model, which "assumes that social problems exist naturally in the social world" and seeks to measure them and evaluate possible solutions.(7) Constructionists, on the other hand, examine how social actors create social problems and compete to control their initial definition and ultimate resolution.(8)

   Constructionists see the competition surrounding social problems as a political process that unfolds in two basic stages. These stages constitute the career or life cycle of a social problem.(9) In the discovery phase, social actors make claims about the social problem to attract public attention. In the subsequent institutionalization phase, social problems that have attracted enough attention become routinized, typically in bureaucratic government agencies. In the second phase, social actors can no longer argue that a problem does not exist; they must respond with an effort to "do something about it."(10) This response, however, is not predetermined by the initial definition of the problem. Rather, the institutionalization phase is a dynamic process in which the problem takes on new life that may completely redefine it. "The significance for students of social problems," Gomez concludes, "is that even in the post-discovery stage, social problems take on a life of their own and emerge institutionalized in ways that are both quite unpredictable and different from claims-makers' agendas."(11)

   Among the forces that help to determine a social problem's career are social actors and social norms. Gomez focuses on two California agencies that played a principal role in the interpretation of prenatal substance abuse as a social problem--state legislators and prosecutors. I discuss below Gomez's analysis of the institutionalization of prenatal drug exposure within these agencies, as well as alternative avenues of investigation that the constructionist model suggests.

   1. SOCIAL ACTORS AND THE INSTITUTIONALIZATION OF PRENATAL DRUG EXPOSURE

      Although Gomez includes a chapter on "discovering `crack babies,'" the book's main focus is on the institutionalization of prenatal drug exposure as a social problem. Gomez investigates how two critical sets of social actors--prosecutors and legislators--responded to the initial claims made by the media and the medical researchers about prenatal drug use. Gomez borrows her method, like her theoretical orientation, from sociology. She uses the life cycle of the problem in California as a case study for applying the constructionist model to this issue. In addition to reviewing government documents and newspaper articles, Gomez interviewed twenty-one legislative insiders, including legislators...