Look, just don’t be a pregnant or nursing mother in South Carolina, okay?

Emily Horowitz tells us about a case that’s sure to make hundreds of thousands of women make appointments to have their tubes tied. Despite a total lack of scientific evidence, prosecutors in South Carolina are charging Stephanie Greene with the murder of her fourth child, 5-week-old daughter Alexis, because Stephanie was nursing Alexis while taking prescription painkillers.

Stephanie lives in Campobello, South Carolina. Prosecutors allege that Stephanie took so much prescription medication that her daughter Alexis died of a morphine overdose ingested via breast milk. The coroner’s report shows the cause of death as drug overdose, because the infant had an elevated blood level of morphine. The case is complicated, because there is no question that Stephanie takes a significant amount of prescription medication for physical ailments (i.e. fibromyalgia, chronic pain, high blood pressure) resulting from a car accident, including MS Contin (a drug that metabolizes as morphine).

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After arriving home, Stephanie says a lactation consultant from the hospital called to see how she was doing with her breastfeeding. Stephanie revealed her medications to the consultant – including the MS Contin. The consultant referred her to a website run by NIH with a comprehensive list of drugs and their compatibility with breastfeeding. The consultant told Stephanie she got all of her information from the site, and Stephanie accessed it and found the that morphine is relatively safe for nursing mothers, with breastmilk levels ranging from “trivial” to “quite low.”

The NIH says the drugs she was taking were fine while nursing, but Tony Ivey from the county sheriff’s office knows better, right?

A spokesperson for the county sheriff, Tony Ivey, was quoted in these reports saying that that toxicology proves that the infant died directly from medication ingested from Stephanie’s breast milk, and that Stephanie is fully responsible for the death of the infant, noting “Taking care of children and raising children is very serious business, and if you’re taking medication or whatever, follow the doctor’s guidelines, consult your doctor, because this is something that should never have happened to an infant child like that. It had no control over this whatsoever and the mother should’ve known better.”

In spite of what Ivey says, Stephanie was taking medication prescribed by the same doctors she had seen regularly over the past few years, and records show that she received all her prescriptions from the same pharmacy. Her doctors continued to prescribe medication after the death of Alexis and only stopped following Stephanie’s arrest.

Even putting the facts aside (Greene was consulting her doctor) and the available research on the subject (it’s extremely unlikely for a mother to get enough opiate in her milk to kill her nursing infant), the language Ivey’s using is of neglect, not murder. He’s implying that she was taking drugs recreationally and didn’t give any thought to how it would affect her newborn daughter. This is a serious accusation, but it is not the same thing as murder. It may be manslaughter, or negligent homicide, but a murder charge implies that Greene knowingly and deliberately overdosed her baby by nursing. I suppose they’re overshooting based on the assumption that she’ll plead to a lesser charge, but the idea of “murder by nursing” is so lurid that it doesn’t even pass the trashy novel test. Breastfeeding requires initiative and dedication and especially in the first few months can be a real pain in the tits (excuse my pun). Formula can be purchased at any supermarket and bottle-feeding is in many ways less demanding than breastfeeding. (I mean, we don’t have a formula-usage equivalent to lactation consultants, for example.) If someone wanted to kill that baby by morphine overdose, it would’ve been way, way easier to just put some opiate in her bottle. In fact, if the baby’s morphine level was really as high as the coroner’s office says, that is probably what happened, but for that, the police would have to look at more than just the mother.

Horowitz’s larger point is that Greene has been targeted by a legal culture that treats women like criminals for being imperfect mothers:

In the hospital, Stephanie did not reveal that she was taking any medications at all, even though she was asked multiple times by multiple people. Stephanie was sheepish when I asked her about this. Stephanie says she knew that her medication use would open her up to suspicion. South Carolina is the state, after all, notorious for shackling new mothers to their hospital beds if they (or their infants) tested positive for illegal drugs – and removing infants to foster care and the mothers to jail. Although the Supreme Court ruled this practice illegal, Stephanie had been a nurse in South Carolina long enough to know she was in a state where mothers and pregnant women who use or abuse drugs are viewed with special contempt.

Stephanie was aware that her use of strong opioids (especially morphine) would raise suspicion. South Carolina has aggressively prosecuted women who unintentionally miscarry a fetus after illegal drug use. Although the state has come under fire from advocate for these racist (although Stephanie is white, almost all the women convicted of this charge have been African-American and poor) and problematic policies, a woman like Stephanie knew it was not a good idea to openly discuss her painkiller use while in the hospital.

The result of hospitals acting like a wing of law enforcement, and the court system acting like the Womb Police, is that women who are dependent on drugs, whether under a doctor’s supervision like Stephanie Greene or using illegally due to addiction, are extremely hesitant to disclose their chemical dependence to health care professionals. Those whose drug use really does put their children in danger would be much more likely to get the help they need if they could trust the system to treat them like patients rather than criminals. It’s awfully tricky to seek medical care when the hospital is a direct line to the police station.

2 thoughts on “Look, just don’t be a pregnant or nursing mother in South Carolina, okay?

  1. You forgot the part where she wasn’t obtaining her medications legally. So possibly there is more to the story than SC being evil, ya think?

  2. According to Horowitz’s article, she was obtaining her medications by prescription from her regular doctor and always from the same pharmacy. And even if she was doing something illegal to feed her drug habit, that’s still quite a far cry from knowingly killing her daughter.

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