By Jonathan McFadden
2010-06-10. Rock Hill.Lake Wiley Pilot. Kristian McManus said that a week before she gave birth to a son, she took Lortab and Klonopin to calm her nerves and stop her pain. An hour before delivery, she swallowed half a Percocet.
“I was in so much pain,” she said. “When that pain came, I couldn’t help myself.
“What I did was a mistake.”
On Feb. 17, McManus, 22, gave birth to Brendyn Perdue. Four days later, the York County office of the Department of Social Services took custody of the newborn and McManus’ daughter, 1-year-old Mary Katherine Perdue, after doctors told police she tested positive for opiates and benzodiazepines in her system just before delivery.
According to a Rock Hill police report, she had trouble staying awake during labor. Test results determining if the baby tested positive for drugs are pending, said Rock Hill Police spokesman Mark Bollinger.
Police investigated and last month issued a warrant for McManus, saying she took benzodiazepines not prescribed to her during her third trimester and put her child “at an unreasonable risk of harm.”
Benzodiazepines act as sedatives and relaxants, and can be detected in urine tests for hours or weeks depending on the drug. They are sometimes prescribed to pregnant women to treat anxiety.
Charges were filed against McManus because the drugs were found in her system before delivery, and social services officials were concerned she would be unable to properly care for her child, Bollinger said.
McManus turned herself in to police and was charged with unlawful conduct toward a child, a felony carrying a maximum 10 years in prison. She was released from jail on a $3,000 bond. Her court date is in July.
She hopes her “kids will return to me” this month after an upcoming appearance in family court. DSS declined to comment.
Loss of mother
McManus picked up her first bottle of prescription medicines two years ago after she learned her mother had been shot to death.
In April 2011, police found Katherine Ballard McManus, 43, dead from gunshot wounds in a Virginia home. Her boyfriend was charged with murder. A year later, he pleaded guilty to manslaughter and was sentenced to 10 years behind bars followed by three years of probation.
Kristian McManus and her mother weren’t always close, she said.
“She was never there. Every time I’d wake up, she would be in a police car,” she said.
Still, McManus questioned if her mother forgave her for their soured relationship.
“I couldn’t deal with how I treated my mother,” she said. “I wish we could’ve had a better relationship. That’s what I struggled with. That’s when I had my breakdown.”
She turned to pills to soothe her pain. Lortab, an opiate, and Xanax and Klonopin, both benzodiazepines, were at her fingertips.
“Some people had access to meds and I could get them whenever I wanted them,” she said. “It made me forget about everything. I didn’t know how serious it was.” But, “it didn’t stop me from being a mother.”
McManus put the pills away during her first pregnancy. While carrying her daughter, she said she suffered from toxemia, a blood disorder affecting some pregnant women that left Mcmanus with a swollen face and feet.
The pain ended when Mary Katherine was born. Four months later, McManus learned she was pregnant again. It wasn’t planned, she said, and the pregnancy was painful. Still, she resisted the lure of pain meds.
Three days before giving birth, pain drove her back to Klonopin. She said she went to Piedmont Medical Center, asking to be admitted because her contractions were severe. Each time, doctors at the women’s center refused to admit her because the contractions weren’t “close enough,” she said.
Piedmont Medical Center declined to comment on the situation or discuss labor and delivery procedures at the hospital.
McManus couldn’t sleep for three days due to pain, she said. She took a Lortab to calm down and half a Percocet, a pain reliever, before she was finally admitted into the hospital.
During labor, doctors gave McManus an epidural, she said. She was alert, she said, denying police accusations that staff had to wake her up to deliver her son.
After Brendyn’s birth, the county Department of Social Services began an investigation because of the drugs found in McManus’ system. According to police and McManus, DSS took custody of her children. McManus said both children were placed in foster care with a family in Lake Wylie. The foster parents declined to comment.
“I never should have taken my kids for granted,” McManus said.
According to Susan Dunn, legal director for the American Civil Liberties Union of South Carolina, McManus never should have been arrested.
“If the problem is risk to the fetus, drug use is in there with a whole category of things a mother should or should not do,” Dunn said.
Isolating drug use from other risks women explore during pregnancy is a double standard, Dunn said, and promotes the idea that expectant mothers should be held to incredibly high standards.
“The crimes these people are being arrested for is not distribution of drugs and not even possession of drugs,” she said. “What they’re being criminalized for is the relation of pregnant women and their fetus, and that becomes a kind of discrimination against pregnant women.”
Doctors might tell a mother in her last trimester of pregnancy not to work, despite the fact that she’s single and already has two other kids to support, Dunn said.
“She may have to keep working and try to gamble with the risks,” she said. “If she makes that choice and it ends up being wrong and in part attributes to a poor pregnancy result, are we going to punish that mother?”
Taking the risks doesn’t mean mothers are responsible for the pregnancy outcome, Dunn said. “That’s the result of a whole bunch of other things.”
“Pregnancy is just a huge gamble that we all need people to take. If we waited for the perfect mother, then none of us would have ever been born,” she said.
Dr. Robert Newman, director of the Baron Edmond de Rothschild Chemical Dependency Institute at New York’s Beth Israel Medical Center, said he was unaware of “credible studies” showing lasting short-term or long-term effect in a fetus exposed to opiates.
“There are many other issues that are very often associated with opiates during pregnancy, like smoking, alcohol use, lack of prenatal care, lousy nutrition. All those issues can have a profound impact on the pregnancy,” he said. “In terms of a generalization, does opiate exposure in utero hurt the baby? There’s absolutely no evidence to support that contention.”
Another misperception, Newman said, is that women who use drugs during pregnancy are engaging in “hedonistic behavior” and don’t care about their unborn children.
Both the American Medical Association and National Drug Institute define drug addiction as a disease, or serious medical problem, affecting the brain and behavior.
“The practice in this country is to overwhelmingly discourage women who are drug dependent from seeking help,” Newman said. “Rather than advocating treatment, pregnant women who are opiate-dependent are getting the opposite message: If your baby is born with evidence of drugs, we’ll prosecute you.”
In 1997, South Carolina became the first state to uphold a conviction against a mother who used cocaine during pregnancy. The state Supreme Court ruled that a “viable fetus” in the third trimester is considered a person, and protected under the state’s child welfare laws.
Today, 17 states consider substance abuse during pregnancy to be child abuse, and three consider it grounds for civil commitment, reports the Guttmacher Institute, a nonprofit advocating reproductive and abortion rights.
The risks often vary from “drug to drug,” although alcohol, by far, is the most harmful to children in utero, said Brenda Dawkins, treatment director for adult services at Keystone Substance Abuse Center in Rock Hill.
Dawkins said media hype about “crack babies” shaped perception that children born to drug-addicted mothers will ultimately be addicted themselves.
“A mother who is using cocaine when her baby is born, it’s not even addicted,” Dawkins said. “It’s not born addicted to any drug. It may be in distress.”
Keystone in 1997 started housing pregnant drug-addicted women when law enforcement started prosecuting them, doctors and hospitals became “mandated reporters” and women stopped seeking prenatal care for fear of arrest, Dawkins said.
“Most of the time, (the mother) just doesn’t understand that the disease of addiction does not automatically stop for nine months,” she said. “This is a disease and she cannot stop without help. She really doesn’t want to hurt that baby, but she doesn’t know how to stop.”
Dawkins said there’s no conclusive medical study showing how opiates might harm the fetus. But benzodiazepines might do damage because the detoxification process is longer than any other drug.
“These babies should be OK, the ones that aren’t on alcohol,” she said. “Sometimes, we don’t know that until they are a little older. We haven’t seen severe developmental disabilities from these drugs.”
Willy Thompson, deputy 16th Circuit Court solicitor, said a positive test for a substance isn’t the “end-all in what you charge.”
“We get the entire birth record, the prenatal care records, look at the actual physical nature of the child when the child is born. There’s any number of things that we look at to help guide how we can charge.”
Prosecution isn’t always the solution, Thompson said, and the solicitor’s office in some cases hasn’t charged a woman because it was proven that the drug did not harm the child.
York County solicitors have focused efforts to help rehabilitate mothers who are on drugs, whether that be recommending probation or clinical drug treatment, he said.
“The first reaction has never been...we’re going to throw the mother in jail and we’ll throw away the key,” he said. “We try to help and allow that child to be raised with the mother.
“You don’t want someone to be hindered from receiving treatment to correct the issue, to get treatment for the child and prenatal care because they fear they’ll be arrested,” he said. “Most people don’t say, ‘I’m going to destroy this child.’
Their addiction helps drive them to make decisions in favor of the drug rather than for the child, he said.
When helping doesn’t work, punishment does. Prosecutors have secured convictions for mothers who “repeatedly” expose their unborn children to illegal drugs, Thompson said.
“You can’t divorce the fact that someone who exposes their baby to illicit drugs is the exact same person who raises them in a poor environment,” he said. “Those two go hand-in-hand.”
Thompson said it’s best for law enforcement to intervene when the problem first surfaces, but “if we cannot do that and that person will not allow us to help them, then we have no choice. You have to separate the child from that parent.”
‘Stand by her’
Elizabeth Perdue’s niece and nephew have been gone for four months. She’s known McManus for 10 years, ever since they started dating each other’s brothers.
“She’s made a lot of progress,” Perdue said. “She went from being a bad addict to being around people who get prescriptions day-in and day-out and not be bothered by it.”
She believes circumstances drove McManus to pills. The father of McManus’ children is in jail. Her employer closed, and after her mother’s death, McManus “had no energy” and “was hurting left and right,” Perdue said.
Many people turned their backs on McManus when she started taking pills and stealing from family members, Perdue said.
“I was the only one to stand by her,” she said. “I never turned my back on her. As long as someone’s there to support her, she’ll do right.”
But, Perdue doesn’t excuse McManus’ actions.
In the time McManus has been clean, she’s learned that Klonopin and Lortab only relieve “pain for the moment; it doesn’t last. Why take them if it ain’t going to help it? It just helps the situation for the moment.”
For eight weeks, she attended counseling and drug treatment sessions at Keystone Substance Abuse Center.
She attends church and keeps CD’s from the sermon in her purse. She’s secured housing on the Catawba Indian Reservation, she said.
Critics call her “stuck-up,” she said, because she’s gone “cold turkey.”
Two months ago, she was in a car accident and was diagnosed with a pinch nerve in her spine. Doctors prescribed her pain pills. She hasn’t touched them.
“I made a big mistake,” she said. “I’ve got a second chance.”