PubMed · 4279166
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J W Klein, L A Randolph. Placing handicapped children in Head Start programs.. https://pubmed.ncbi.nlm.nih.gov/4279166/
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Pregnant women who abuse drugs, such as alcohol, cocaine, and marihuana may face a variety of legal and social responses, including involuntary commitment, forced treatment, and criminal sanctions. These programs are intended to remedy apparent maternal-fetal conflicts but paradoxically may encourage some women to avoid beneficial medical and social services or to seek abortion. Although pregnant women have ethical duties to give due consideration to their offspring, these moral obligations fail to justify coercive and punitive programs regarding substance abuse. Coercive fetal protection policies may undermine pregnant women's trust and cooperation, violate their autonomy, weaken our civil liberties, and raise a host of ethical problems relating to race, gender, and class prejudice. Education and drug treatment programs, rather than punitive and coercive measures, may better help pregnant women fulfill their moral duties to refrain from abusing substances.
Using data from the first round of Demographic and Health Surveys for 22 developing countries, we examine the effect of maternal education on three markers of child health: infant mortality, children's height-for-age, and immunization status. In contrast to other studies, we argue that although there is a strong correlation between maternal education and markers of child health, a causal relationship is far from established. Education acts as a proxy for the socioeconomic status of the family and geographic area of residence. Introducing controls for husband's education and access to piped water and toilet attenuate the impact of maternal education on infant mortality and children's height-for-age. This effect is further reduced by controlling for area of residence through the use of fixed-effects models. In the final model, maternal education has a statistically significant impact on infant mortality and height-for-age in only a handful of countries. In contrast, maternal education remains statistically significant for children's immunization status in about one-half of the countries even after individual-level and community-level controls are introduced.