A Clean Start : Instead of punishing pregnant addicts, a program aims to prepare women for motherhood. The goal? Healthy lives for themselves as well as their babies.

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 masseuse.

But Kenneth Chinn was worried about the welfare of his wife and unborn child, so he called Orange County child-abuse authorities for help. Social worker Raquel Amezcua went looking for Chinn at the motel on that same September day. But by the time she arrived, the 23-year-old Fountain Valley woman was gone.

Undaunted, Amezcua tracked 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 that they will be less likely to abuse or abandon their children once they give birth.

Known as Advance Outreach, the program is administered by the Orange County Social Services Agency. It 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 Mary Harris, project director.

Similar programs operate in Tarzana, West Covina and Los Angeles.

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, such as when to take newborns for medical checkups.

When 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 (Amezcua) 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, 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 has been 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 in tax money 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 a pregnant woman having drink after drink.

To overcome their clients’ 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 prenatal and postnatal care--sometimes driving them to their appointments and sitting in the examining room to reassure them.

Chinn says she was introduced to marijuana in the ninth grade. She lost control later that year, she says, 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, who acknowledges that he was drinking heavily at the time. They married five months later, and in 1991, she got pregnant.

Although Kathryn Chinn stopped taking speed during her first pregnancy, she says, 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 says. “But I didn’t even think about pot causing birth defects.”

Soon after the birth of her son, Kory, in January, 1992, Chinn says, she started taking 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.

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 recalls, 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 hospital and asked for something to eat. About three weeks after that 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,” Chinn says.

It has been just more than three months since she took her last hit of speed, Chinn says. So far, says the pediatrician who delivered Koralynn, the baby appears healthy. But the Chinns know that only time will tell.

According to the National Assn. for Perinatal Research and Education, last year about 375,000 newborns were exposed to illegal drugs in the womb--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 before the age of 18. In contrast, an outpatient treatment program for a pregnant woman on drugs runs about $11,000.

But the women are difficult to reach.

Many of the women in the Orange County program are addicted to hard-core drugs such as heroin and cocaine, and have criminal records dating to their early teens. Quite a few have other children whom the courts ordered into foster care because of neglect or abuse. Some are HIV positive. And a lot of the women are also homeless.

Program officials are still in touch with just more than half of 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 living with the mother, says Harris, the program director.

“We aim for the hardest cases,” she says. “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.”

Some women’s periodic relapses into drug use complicate the attempt to determine how successful the program has been. Critics dispute the notion 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?” he asks. 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 that 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 says. “But the first thing I say to them is, ‘I’m clean and sober.’ ”