Social History ( Vignette)
Simone Harrison a 25 year old African American female, who is 6 months pregnant and unemployed, arrived at the University Hospital's Women Clinic in Oakland, CA for prenatal care. Ms. Harrison made the appointment because she has not been feeling well lately. During the intake process , she discloses to the nurse that this is only her second visit to the doctor since finding out she was pregnant. Ms. Harrison's records also contain information about her mental status, most notably that she was diagnosed with schizophrenia in 2009. Her boyfriend, the baby's father, decided he wasn't ready to be a father and left shortly after finding out about the baby. Fear, abandonment, and uncertainty about the future escalate stress levels consequently resulting in her experiencing auditory hallucinations. When this happens, the client, who is uninsured, self medicates with cocaine to manage her symptoms. The nurse who works in the clinic suspects that Simone is using drugs because according to her "she looks like the type". Acting out of contempt for the patient and concern for the unborn child, the nurse is ready to drug test Ms. Harrison, without her knowledge if necessary, to confirm her suspicions.
Context of the Case
Drug (alcohol, tobacco & cocaine) addiction is accepted by the medical community as a disease. The medical model explains that consuming drugs excessively is a symptom of this medical condition. However, those in power that adhere to a conservative ideology do not accept the medical model's explanation as to why pregnant women would continue to use drugs knowing the adverse affect this will have on the fetus. Historically punitive measures involving incarceration and subsequent removal of the remaining children from the home are among the actions taken to resolve the problem. In some states [if Ms. Harrison] tested positive for drugs and/or alcohol in her system while pregnant [she] could be prosecuted for child endangerment or delivering drugs to a minor via the umbilical cord (Mohapatra, 2012).
Since the crack epidemic back in the 1980's to the present studies have confirmed that prenatal substance abuse (alcohol, tobacco & cocaine) remains a significant problem. The vignette discusses the plight of a poor mentally ill African American female, but the populations who are affected by this problem vary in terms of race, class and socioeconomic status. As reported by the Center for Behavioral Health Statistics and Quality pregnant black women (7.7%) are more likely than pregnant white (4.4%) or Hispanic (3.1%) to use illicit drugs like cocaine (SAMSHA Website, 2012). Whereas pregnant white women (21.8%) are more likely than pregnant black (14.2%) or Hispanic (6.5%) women to smoke cigarettes or consume alcohol, which is equally as harmful to the developing fetus (SAMSHA Website, 2012). Pregnant women of different races and ethnicities display diverse patterns of substance abuse, but...