The $200 Question

On Feb. 24, 26-year-old Stacey Davis, broke and recovering from an addiction to speed, checked into a Long Beach hospital, where a doctor sterilized her by tying her tubes. The next day, an Orange County organization mailed her a check for $200.

“I’m not going to lie,” said Davis, a mother of three children in foster care. Although certain she didn’t want any more children, she was also attracted by the promise of a reward. “I mean, I need the money right now. I need to do something for me.”

Davis is one of eight women who have been sterilized and have taken part in a controversial cash-for-contraception program created by the Anaheim-based CRACK (Children Requiring a Caring Kommunity).

Others who have received money from CRACK after having their tubes tied at area hospitals include a 28-year-old Los Angeles drug user with five children in foster care, a 38-year-old Los Angeles recovering drug user who has given birth to 14 children, and a 32-year-old Anaheim methadone user with six children. Combined, the eight women have given birth to 51 children, 43 of them in foster care, according to CRACK founder Barbara Harris, of Stanton, who has adopted four drug-exposed babies.

The small but growing private program concerns leaders from Planned Parenthood and the American Civil Liberties Union who worry that the cash offer will, in effect, coerce drug users who are poor into making an irreversible choice they may later regret.

“The issue is whether a woman who decides to undergo such a procedure does so voluntarily and with full consent,” said Rocio Cordoba, a staff attorney for the ACLU of Southern California. “If a woman is given financial incentives to do so, that raises questions. Two hundred dollars could mean a lot to somebody who has nothing.”

Now opening its first office in Anaheim, the group has raised $35,000, including $25,000 from an out-of-state businessman who insists on remaining anonymous. Radio personality Laura Schlessinger has contributed $5,000, and conservative talk-show host Rick Roberts has raised funds through his San Diego radio program. Board members include two social workers, and Los Angeles County Sheriff Sherman Block, chairman of the Inter-Agency Council on Child Abuse and Neglect, is an honorary member.

Advisory board member Carole Rowe said CRACK’s program is not based on an extremist ideology and takes no position on abortion.

“We’re committed to a voluntary program, which includes not coercing a woman into rehab if she’s not ready,” said Rowe, a Los Angeles attorney.

CRACK has enlisted seven more potential clients, Harris said, including another Los Angeles drug user, 23, who is planning to undergo sterilization this month after delivering her fourth child.

To find participants, the group sent fliers to hospitals, police departments, probation departments and jails in Los Angeles and Orange counties. One woman called after her social worker gave her a flier. Another called after hearing Harris interviewed on a radio show. This month, Harris is expanding advertising to bus benches outside welfare offices and hospitals in the poorer districts of Los Angeles and Orange counties.

Without universal drug testing in hospitals, Harris said, rich women can evade detection more easily. “It’s not ever going to be fair,” she said. “My focus is just going to have to be on the poor babies. That’s the bottom line.”

The program offers $200 for a tubal ligation, a Norplant insertion or a vasectomy in the case of male addicts. The figure was considered “motivating, but not coercive,” said Harris, adding that all the women so far have chosen sterilization over long-term contraception. To qualify, participants must have at least two children and must obtain verification from a doctor within 60 days before they are paid; if they don’t know where to go, Harris offers referrals to Planned Parenthood or a free clinic. The program does not pay for the procedure, which can be financed through Medi-Cal or other subsidies.

It is up to the providers to see that the women are fully informed and consenting, Harris said.

Added Rowe, “They don’t make a decision while they’re still stoned. A person needs to sign a state waiver form to receive sterilization services, and that presumes they’re competent at the time.”

The process isn’t always smooth. One drug user, a homeless, 29-year-old mother of two, tried to obtain Norplant and then disappeared after Planned Parenthood providers told her she needed to schedule an appointment for the procedure.

When Davis, the recovering speed addict, heard about CRACK from a fellow resident in her drug recovery program, “I thought, ‘Great, I could use the money. And I’m going to do it anyway.’ ”

Sitting in the spartan apartment she shares with two other recovering addicts in a Compton residential treatment program, Davis recounted without emotion her hard-luck life story that began when her mother walked out on her father, leaving the Pomona mechanic to raise 2-year-old twins by himself. He did a good job, she said. Still, Davis dropped out of high school to have a baby and later had two more with two other men--both drug addicts who drifted in and out of prison. (Her twin sister, a mother of six, is also in a recovery program, she said.)

At the time, she said, methamphetamines were far more important than birth control. When she got pregnant, she had abortions. The second abortion, however, left her feeling so guilty that she deliberately became pregnant again. After authorities removed both children for drug-related neglect, she found out she was pregnant for a third time. The baby was born after she finished serving a sentence for forgery.

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“I felt a lot of guilt within myself having a baby and my other kids being in the system,” she said. “But in a small way, it helped me ease the pain of my kids being gone, having another baby. My stupidity is I started using again and the baby got taken from me and I had to explain to my daughter why. I put my kids through a lot.”

Davis made her decision after six months in the recovery program, which is supported largely by government grants and run by Shields for Families Inc., a nonprofit organization.

She is now sure she doesn’t want any more children. “I have three beautiful children. I’m trying to focus on getting them back and turning my life around. I can’t see me having any more kids that would get in the way.”

If she can’t convince a judge to return her children, “I’m not going to have any more kids for them to take away from me.”

Sober and lucid, Davis made an informed choice for the right reasons, said Shields executive director Kathryn Icenhower. She is appalled, however, that more vulnerable women are being targeted for the cash incentive program. It is “taking advantage of women who are addicted. They are not in the position to make their own life choices when they are under the influence,” Icenhower said.

“It’s a quick Band-Aid to a long-term problem. To me, you have just encouraged women to keep on using. It means you’ve given up.”

Dr. Xylina Bean, chief neonatologist at Martin Luther King Jr./Drew Medical Center in South-Central Los Angeles, is also disturbed by CRACK’s approach and growing acceptance. “My initial feeling was that these people were well-meaning but misguided,” she said. But she began to think the problem was more serious after the hospital received fliers from the group urging women, “Don’t let pregnancy ruin your drug habit.”

Harris explained the slogan was suggested by former addicts. “To a woman who’s still using, that’s all she cares about--her next high,” Harris said.

“It is not a therapeutic approach,” said Bean, adding that she believes a focus on minority communities “feeds latent racism.”

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Harris says she doesn’t contact individuals in recovery programs. “They call me,” she said. “Somebody in [the program] is referring them to me.”

Icenhower said she did not know how CRACK got names of individuals in Shields’ program, adding that most clients and staff members are “very offended” by the cash offers.

Harris noted her program targets Orange County as well as Los Angeles, and her clients are almost evenly divided between white and black.

“Our intentions are only good,” she said. If addicted women take advantage of her drugs, or the fact that they are allowed to continue to give birth to drug babies? Come on. Which would weigh heavier on anyone who has a heart?

“I’ve thought long and hard about it. These women have to be on birth control by any means necessary. That’s where we come in.”

Some social workers, frustrated by the sight of newborns in withdrawal, repeated births to the same drug user, foster children shackled by a “crack baby” label, or elderly grandparents overwhelmed by child-care responsibilities, also support the cash incentive program.

“How many children’s rights are you willing to sacrifice for one woman’s?” asked social worker Denise Prybella, a member of CRACK’s advisory board.

Board member Rowe said opponents “are wholly ignorant to the suffering that goes on on the part of the mother, the child, the taxpayer and the public schools.”

The majority of children under county jurisdiction come from substance abusing homes. “Of the number of people who do have drug-exposed children, they have an enormous number of children. Sometimes it is a symptom of drug abuse to have so many,” Rowe said.

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One Orange County grandmother, caring for her granddaughter, called Harris hoping she could persuade her daughter, a former cocaine addict who is pregnant for the sixth time, to be sterilized. “My granddaughter has no mother, no father, and now she has to see her little brother or sister given away. She shouldn’t have to see that,” she said. “I get sick every time a baby is unwanted or given away and I don’t want to raise another one. I’m 59.”

The daughter, 35 and living in a Catholic home for unwed mothers, angrily rejected the form that Harris sent her, her mother said.

Forces driving substance abuse and unplanned pregnancy are too complex to be turned around by sterilizing individual substance abusers, said Bean, co-founder of the Shields recovery program. In recent years, the numbers of drug-exposed babies at King/Drew Medical Center have been cut by more than half from a high of 600 a month, partly as a result of community-based programs that increase access to treatment and follow-up services, she said.

Once pregnant women get into a program, they have a 75% success rate. However, many others are lost between the time they’re identified in the maternity ward and before they enroll in a program, Bean acknowledged.

Education and treatment programs may be more effective, but there are not enough programs to deal with the problem of drug babies, said Sheriff Block. While he favors cash incentives for contraception, he said he was unaware Harris’ program also paid for sterilization. “I would not support sterilization under any circumstance,” he said.

Knowing how desperate addicts can be to finance their next hit, Davis believes many will jump at the chance to earn the $200. To her, however, the transaction will buy a day of sober fun at Magic Mountain with a girlfriend. “I deserve it,” she said.