There have been numerous instances when media have seized on a supposed medical "phenomenon" and hyped it beyond recognition, distorting facts irresponsibly or simply getting them wrong. But few media fabrications have been as invidious, persistent or politically devastating as that of the so-called "crack baby."
Mid-1980s case studies suggested a possible link between women's cocaine use during pregnancy and a range of damaging effects on babies. Already obsessed with the use of the cocaine derivative crack among the urban poor, mainstream media used these limited, qualified findings as grounds for an astonishing spree of sloppy, alarmist reporting and racial and economic scapegoating that still echoes today.
The hysteria and sheer meanness of the initial assault are captured by a 1989 Washington Post column by Charles Krauthammer (7/30/89 ), which began: "The inner-city crack epidemic is now giving birth to the newest horror: a bio-underclass, a generation of physically damaged cocaine babies whose biological inferiority is stamped at birth."
Krauthammer cited the American Enterprise Institute's Douglas Besharov (the man to thank for the blood-chilling term "bio-underclass"), who says: "This is not stuff that Head Start can fix. This is permanent brain damage. Whether it is 5 percent or 15 percent of the black community, it is there." Krauthammer compared cocaine-exposed children to "a race of (sub)human drones" described in Huxley's Brave New World, and pronounced that their "future is closed to them from day one. Theirs will be a life of certain suffering, of probable deviance, of permanent inferiority. At best, a menial life of severe deprivation." In his opinion, "the dead babies may be the lucky ones."
Looking back, one could rejoin that such outrageous, racist misinformation is not the kind of stuff corrections can fix, even had one been offered. But though his bias is particularly overt, Krauthammer was not alone in his essential argument - that children whose mothers used cocaine during pregnancy are scientifically identifiable as "crack babies," with permanent, catastrophic biological damage that leaves them incapable of being anything but menaces to society.
Veneer of Sympathy
"Crack baby" stories typically had an anecdotal focus and a veneer of sympathy for the "tiny victims," like "three-month-old Sabrina," described in the St. Petersburg Times (11/19/89). She "appears to be a normal baby," but "Sabrina's life has been a three-month trip through hell, and the trip isn't over." More urgency was reserved, though, for the unimaginable dangers these babies were supposedly destined to wreak on the world: The Washington Post (9/17/89) warned of "A Time Bomb in Cocaine Babies," while the St. Louis Post-Dispatch (9/18/90) declared flatly, "Disaster In Making: Crack Babies Start to Grow Up."
Such inflammatory rhetoric drowned out any real-life complexities reporting might have revealed. For example, in "Crack's Toll Among Babies: A Joyless Vew, Even of Toys" (New York Times, 9/17/89), the final paragraph describes a day care program where crack-exposed children, given individual attention, are improving greatly. Readers, howwever, are much more likely to remember the article's second paragraph, in which a psychologist claims that prenatal use of crack interferes "with the central core of what it is to be human."
Likewise for Time Magazine (10/1/90), where what in a more reasoned debate would be crucial information - the fact that "few drug treatment programs...accept pregnant addicts" - is buried amid emotional filler like the reporter's assertion that "maternity wards around the country ring with the high-pitched 'cat cries' of crack babies."
One San Diego Union-Tribune article (2/2/92) even gave space to a prominent medical researcher's plaintive statement that, "These children are not prenatally doomed. They are not the little terrors that everyone says they are." But the paper's headline spoke louder: "Drug Babies Invade Schools."
The emphasis may have varied, from pity for the children ("Crack Babies Born to Life of Suffering," USA Today, 6/8/89) to disgust for the mothers ("For Pregnant Addict, Crack Comes First," Washington Post, 12/18/89) to the unfathomable amount "their" problems might wind up costing "us" ("Crack's Tiniest, Costliest Victims," New York Times, 8/7/89). But overall, commercial media found the premise - a coming onslaught of affectless genetic deviants - utterly persuasive.
Hanging on to the Myth
The premise, however, was false. The inadvisability of using cocaine during pregnancy is not disputed. But subsequent research on cocaine-exposed children found that many of the dangers mentioned in initial studies are simply not borne out.
A retrospective survey (or "meta-analysis") of 1980s research found serious methodological flaws, from a failure to distinguish cocaine exposure from exposure to other drugs, to a lack of control groups (Teratology, 1991; 44:405-414). Health-care providers working with infants exposed to cocaine in utero found them indistinguishable from other children. Much medical research pointed to other factors - such as the lack of good prenatal care, use of alcohol and tobacco, and, simply enough, poverty - as more primary factors in poor fetal development among pregnant cocaine users than cocaine itself.
Proponents of a revised view included Dr. Ira Chasnoff, whose initial 1985 study launched much of the media juggernaut. By 1992, Chasnoff was saying, "poverty is the worst thing that can happen to a child," and expressing dismay at the press' misuse of medical research. "It's sexy," he suggested of the "crack baby" story (AP, 12/6/92). "It's interesting, it sells newspapers and it perpetuates the us-vs.-them idea."
Not surprising, then, that the new medical consensus failing to support a link between prenatal cocaine exposure and catastrophic biological or developmental problems garnered a tiny fraction of the media attention devoted to the idea that "Parents Who Can't Say 'No' Are Creating a Generation of Misery" (L.A. Times, 9/21/89). What coverage there was suggested media found the tale of a "bio-underclass" too compelling to abandon. To hang on to it, some reports constructed absurd straw men, as when Newsweek (9/29/97) explained that, if predictions of cocaine's "sledge-hammer" impact on the fetal brain were unfounded, "neither is it a prenatal vitamin."
Or reporters might tuck in a parenthetical admission like, "experts are quick to point out that legal drugs such as alcohol and nicotine can produce far more drastic effects than cocaine, lowering birth weight and sometimes causing severe physical deformities" (Chicago Tribune, 7/12/98) - without explaining why this information hasn't provoked a flood of reporting on the terrible suffering of "liquor kids," or the exorbitant social costs of caring for "smoke babies." Despite undermining the very premises of the previous discussion, the new research still did not fundamentally redirect the media debate.
Such a sustained media assault was not without real world effects, of course. Years of accusatory coverage contributed to a shift to more punitively focused public policy, which was, in turn, welcomed bv the press. In 1994, 60 Minutes aired a show (11/20/94) celebrating one such policy: a South Carolina law under which women who used cocaine while pregnant were arrested and jailed under child abuse statutes. "Cracking Down," the segment was called.
Fast forward to 1998: Despite an amicus curiae letter signed by 15 leading medical and social service organizations condemning the policy, the Supreme Court declines to hear an appeal in the convictions of two South Carolina women. Cornelia Whitner and Malissa Crawley, both mothers of healthy children, are serving prison terms for prenatally "abusing" them by using cocaine. And 60 Minutes announces plans to re-air its 1994 segment on the policy that sent them to jail.
For Lynn Paltrow, one of the attorneys representing Whitner and Crawley, the 60 Minutes rerun was a very depressing idea. Paltrow told CounterSpin (6/19/95): "I wrote a letter saying please don't rebroadcast information that's inaccurate, or that suggested that this was a policy that worked."
The "Cracking Down" segment focused on the Medical University of South Carolina Hospital, in downtown Charleston. It showcased Nurse Shirley Brown, who host Steve Kroft explained "thought something had to be done," about pregnant drug addicts, and so "working with the police and the social service agencies and the local prosecutor," developed the program of arresting them, sometimes out of their beds. The prosecutor, Charlie Condon, is shown declaring, "It worked like charm."
"And then," Kroft intones, "Lynn Paltrow came to town." Identified as "a feminist lawyer with The Center for Reproductive Law & Policy in New York City, an offshoot of the American Civil Liberties Union," Paltrow was pretty clearly supposed to be the villain of the piece, but it wasn't the depiction of herself that riled her. She objected to the show's underlying presumption of a causal link between prenatal crack exposure and the sickly babies in the intensive care unit, whose fragile, heart-breaking images recurred throughout the segment, and whose "chances of survival," Nurse Brown told viewers, "are real slim."
"This Isn't a Racist Policy"
"The idea that a neonatal intensive care unit in general would be the right image of what a baby exposed prenatally to cocaine was [like], was extremely inaccurate" says Paltrow. But she'd expected it. "In fact, I talked to [producer L. Franklin Devine] and said, I bet they're going to take you to the neonatal intensive care unit and say, 'These are crack babies,' and I beg you to say, 'How do you know?' The truth is, they can't tell."
Indeed, she asked, if children exposed to crack are so "uniquely harmed, so particularly devastated, why doesn't the hospital have a special program to even track them?" Again, the answer is that they are not uniquely harmed, a point Paltrow says she heard repeated often by frustrated medical staff. "Many of the people who are actually working with the women and children were saying, 'These are poverty babies, and nobody wants to address that. So we call them crack babies.'"
Paltrow also protested the selective enforcement of the program, pointing out that of 23 prosecutions, 22 were of African-American women, and the one white woman was married to a black man. 60 Minutes' way of addressing this concern was having Kroft question Charleston's chief of police, who is black: "This isn't a racist policy?" "No," the police chief assures him. "No question about it."
Paltrow knew the 60 Minutes segment painted her as unsympathetic to children. But she is joined by leading medical groups like the American Medical Association, the American Nurses Association, the American Academy of Pediatrics and the March of Dimes in saying, "If you want to help children, don't arrest their mothers." Despite Steve Kroft's claim that "the state's position is the only thing it's trying to do is to have these women stop using crack cocaine. . . . That doesn't seem to be asking a lot. That doesn't seem particularly coercive," no prominent medical organizations seem to think it's good policy to, in Paltrow's words, "threaten a pregnant woman who's coming for prenatal care or substance abuse treatment with arrest - because either she's not going to come at all or she's not going to reveal a problem that we can help her with, if we can provide confidential care."
Unfortunately, a label need not be true to be powerful. Research can't demonstrate that babies exposed to crack in the womb will have any specific developmental problems, but we do know that babies so labeled meet with lower expectations from teachers and parents, and are harder to place in foster care. Media appear uninterested in tracking that particular "phenomenon," however.
Despite the concerns of Paltrow and others, 60 Minutes went ahead and re-aired its 1994 show (5/3l/98), making no mention of the changes in medical research and opinion, or the growing outcry among social service groups protesting turning mothers of cocaine-exposed babies over to the criminal justice system. The program certainly didn't note that their story's main source on South Carolina's racially contentious policy, Nurse Shirley Brown, had testified in court that she objects to interracial marriage.
One change it did make: It added an afterword that claimed Lynn Paltrow "started a letter-writing campaign to try and pressure us into not rebroadcasting this story." The obvious implication, that Paltrow's pleas for them to reconsider perpetuating discredited and damaging claims were an attempt at censorship, led to a protracted attack on the lawyer the following day (6/1/98) by none other than Rush Limbaugh. Actually, it's fitting for this story to have wound up in the repertoire of the factually challenged radio pundit: Amid absurdities like IQ/ breast-size correlation and biodegradable styrofoam, the media's "crack baby" looks right at home.