Project ‘Reaches Out’ to Pregnant Addicts : Intervention: O.C. program seeks to prevent abandonment or abuse by teaching mothering skills.
Four months pregnant and dangerously underweight, Kathryn Chinn called her husband from a Newport Beach motel and left a message on the answering machine.
Not to worry, she told him, deep into her latest speed binge. She had been away the last few days partying with a couple who had hired her as their personal masseuse.
But Kenneth Chinn was worried about the welfare of his wife and unborn child, and called Orange County child abuse authorities for help. Social worker Raquel Amezcua went looking for Chinn at the motel that same day last September. But by the time she arrived, the 23-year-old Fountain Valley woman was gone.
Undaunted, Amezcua continued to track the young woman from run-down apartment buildings to garages to city parks. Eventually, her doggedness paid off. Three weeks later, Chinn signed up for a little-known federal intervention program called the Abandoned Infants Assistance Project and began to turn her life around.
On Feb. 15, she gave birth to a healthy 6-pound, 15 1/2-ounce daughter named Koralynn.
Instead of punishing pregnant addicts for past misdeeds, the program tries to prepare them for the rigors of motherhood in the hope they will be less likely to abuse or abandon their children once they give birth.
Known locally as Advance Outreach, the program is one of four in Southern California and 32 nationwide. Administered by the Orange County Social Services Agency, the program also serves a small number of pregnant, HIV-positive women.
“We reach out to the women and pursue them, and when we see a spark of a desire to do life differently, we are there to fan that flame and make it stronger,” says project director Mary Harris.
Much of the time, the social workers help women meet the most basic of needs, directing them through the bureaucracy toward food, shelter and clothing. During the women’s pregnancies and after delivery, counselors teach parenting skills as fundamental as when to take newborns for medical checkups.
Where gentle persuasion fails, social workers use a more forceful approach. Some might call it coercion, but Kathryn Chinn says it has worked for her.
“I knew she was there to take my kid away if I didn’t stay off drugs,” Chinn says. “But then she made me realize I really did want to stay clean for me--not for no kid, not for no husband, not for nobody.”
By helping women get off drugs, successful intervention programs give children a shot at healthy childhoods. They are spared the traumatic experience of bouncing between foster homes or spending parts of their childhoods in institutions--a sometimes brutal existence that can be linked to criminal and other antisocial behavior later in life.
From a public policy standpoint, the $450,000 Orange County program and its counterparts around the nation save millions of tax dollars that otherwise would be spent on long-term care for drug-addicted babies, supporters say.
Women are referred by law enforcement authorities, relatives, psychiatrists and hospitals; even bartenders have been known to call when they notice an obviously pregnant woman guzzling drink after drink.
To overcome their clients’ preconceived notions of them as uncaring home wreckers, Amezcua and other counselors act as mothers, girlfriends and therapists rolled into one. They carry beepers that put them just a phone call away when a woman is going through an emotional crisis.
They coax the women to doctors’ offices for pre- and post-natal care--sometimes driving them to their appointments and sitting in the examining room to reassure them.
“Doctors might sometimes be prejudiced against a client that has a tattoo to hide the track marks on her arm,” said Amezcua, explaining why some clients are hesitant to seek medical care. “So we try to help them get through that.”
Chinn said she was first introduced to drugs--specifically marijuana--in 9th grade. She “lost control” later that year, she said, when she began experimenting with “crank"--a derivative of methamphetamine. Chinn’s relationship with her mother and stepfather grew increasingly stormy. She dropped out of school, ran away from home, and wound up in foster care.
At 19, she met her husband, Kenneth, who drank heavily. Five months later, they married and in 1991, she got pregnant.
Although Kathryn Chinn stopped taking speed during that first pregnancy, she said she continued to smoke marijuana. Her husband tried in vain to discourage her.
“He would always make jokes about (the baby) coming out with a pot leaf on his thumb or that something would be wrong with him,” Chinn said. “But I didn’t even think about pot causing birth defects.”
Soon after the birth of her son, Kory, in January, 1992, Chinn said she started doing speed again. Things came to a head about a year later, when she moved out, leaving her husband with Kory and $200. The child now lives with Kathryn Chinn’s parents, who have legal custody of him.
Kenneth Chinn--who had become a Jehovah’s Witness, stopped drinking and landed a job as a waiter at an upscale restaurant--began calling every government agency he could think of to get help for his wife.
Finally, someone at the county Health Department referred him to Amezcua.
“There were no visible signs of pregnancy and she was well into her fourth month,” Amezcua says, describing her first meeting with Kathryn Chinn. “She was living behind a Bank of America building.”
Three weeks later, suffering from a severe kidney infection, Chinn went to a local hospital and asked for something to eat. About three weeks later, she made an appointment to see Amezcua.
In addition to helping Chinn with her health and social service needs, Amezcua began to advise the couple about their marital problems. “Raquel has been like a counselor between us and made us realize that we can be friends,” Kathryn Chinn said.
It has been just over three months since Chinn took her last hit of speed, she said. So far, says the pediatrician who delivered Koralynn, the baby appears perfectly normal. But the Chinns know that only time will tell.
According to the National Assn. for Perinatal Research and Education, about 375,000 newborns were exposed to illegal drugs in the womb last year--more than one-fourth of them in California. Many are born addicts and suffer from withdrawal, low birth weight, stunted growth, respiratory difficulties and congenital defects.
According to some estimates, medical treatment, foster care and special education for one of these children can average $400,000. In contrast, an outpatient treatment program for a pregnant woman on drugs runs about $11,000.
But the women are a difficult population to reach.
Many of the women in the local program are addicted to hard-core drugs like heroin and cocaine, and have rap sheets dating back to their early teens. Quite a few have other children that the courts ordered placed into foster care because of neglect or abuse. Some are HIV-positive. And, as if that weren’t enough, a lot of the women are also homeless.
Program officials are still in touch with just over half the 107 women they oversaw in 1991, the first year of the program. They have lost contact with the others.
In 67% of the cases that social workers are still monitoring, the child is still living with the mother, said Harris, the program director.
“We aim for the hardest cases,” she said. “These are not women pregnant with their first child who are getting involved with drugs for the first time. We get a lot of older women who have finally gotten tired of this lifestyle and realize they want to change.”
Sheila Whitlock, a 38-year-old Santa Ana woman, is one.
“Eventually, I was just tired of being tired,” Whitlock said recently, as she nuzzled her one-month-old son, Devin.
Relaxing on the couch in her Santa Ana apartment, the mother of five talked confidently about her progress battling a six-year addiction to cocaine.
She talked frankly about another son, now 3 years old, who lives with foster parents. He has a severe learning disability, she said, because she used cocaine during the pregnancy. She talked regretfully about the 6-year-old daughter who she has not seen in years because the child’s father took her out of the state while Whitlock was in jail on narcotics charges.
While in the jail last June, Whitlock began attending a substance abuse workshop known as Great Escape. Amezcua was one of the discussion leaders.
When Whitlock was released in August, she joined Amezcua’s program.
“Other parenting programs are not as effective because it’s hard to sit among the same elements and go near the same places where you used to buy drugs,” Whitlock said. “Mrs. Raquel is a one-on-one counselor. I consider her a friend and I can discuss anything with her.”
But their relationship was put to the test one recent afternoon when the social worker showed up at Whitlock’s apartment for a scheduled appointment and Whitlock wasn’t there.
A relative who answered the door said that Whitlock had left the baby in the care of family members. But, he said, he had no idea when she would be back.
When two days had passed and Whitlock still had not returned home, Amezcua began to fear the worst. According to social workers, the first 60 days after delivery is the time that a woman is most likely to abandon her child.
Amezcua and her supervisors held an emergency meeting. They decided that if Whitlock did not return soon, they would file a child abuse report recommending that Devin be removed from her home and placed in protective custody.
Whitlock returned the next day. She told Amezcua that she had left suddenly for Tennessee because of a family emergency. She said her sister in Chattanooga had almost overdosed on heroin.
Whitlock went to Tennessee, where she grew up, to make arrangements for her sister’s seven children. She was angry upon her return to learn that Amezcua had thought she might have started using drugs again.
“I really got ugly about that and (when) I saw Raquel, I started chewing into her,” Whitlock said. “But it’s like she said, it’s not like a relapse can’t happen. I ended up apologizing.”
Some women’s periodic relapses into drug use complicate the attempt to determine how successful the program has been. Critics dispute the notion, for example, that teaching women parenting skills will alter the complex web of social ills that leads to child abandonment. Even program supporters believe that the federal government should be doing more to monitor the programs.
“Over the last few years there’s been more and more money, but my concern is that a lot of it is being thrown out without a lot of specific questions being answered,” says Dr. Ira Chasnoff, a Chicago physician who has studied the effects of drugs on newborns.
“The thing is, nobody has really decided what effectiveness means. Does it mean the mother is drug-free and she is keeping the baby? Does it mean she does not abuse the child? Or does it mean that the child has normal, long-term development?” But those questions aren’t easy to answer.
Because the programs are voluntary, none of the women undergo drug testing as they do in court-ordered drug treatment programs. Social workers can only hope the women are telling the truth when they insist they are drug-free.
Kathryn Chinn considers herself one of the success stories. But despite her determination to stay clean, temptation lurks around every corner.
“Every two or three weeks, it’ll never fail, I’ll run into someone from my past and (Kenneth) gets a little edgy. He thinks that maybe they’ll say the right thing to get me back out there,” she said. “But the first thing I say to them is ‘I’m clean and sober.’ ”
In its second year, the Abandoned Infants Assistance Project in Orange helped 124 drug-addicted or HIV-positive pregnant women prepare for motherhood. More than half, 56%, completed the course. A profile of those in the federal program, July, 1992-July, 1993: Age 20-29 years: 61% 30-39: 27% 14-19: 10% 40 and older: 2% Ethnicity White: 61% Latino: 31% Black: 8% How Referred to Program Social services: 24% Self/friend/relative: 18% Jail: 18% Health care: 16% Medical facility: 13% Community agency: 7% Other: 4% Preferred Drugs Heroin: 43% Crack cocaine: 21% Cocaine: 19% Methamphetamine: 13% Alcohol: 4% Infant Placement (Active cases only) Mother: 67% Court supervised care: 28% Relative: 5% Source: Orange County Social Services Agency and Orangewood Children’s Foundation