Pregnancy: South Carolina Supreme Court Overturns Woman's Murder Conviction for Fetal Death After Cocaine Use

The South Carolina Supreme Court Monday threw out the homicide by child abuse conviction of Regina McKnight, the first woman in South Carolina to be convicted on that charge for suffering an unintentional stillbirth after having used cocaine during her pregnancy. In its ruling in McKnight v. South Carolina, the court held that McKnight received inadequate counsel during her trial and that her conviction was based on "outdated" and inaccurate information linking the fetal death to her cocaine use.

McKnight was arrested in 1999, several months after she experienced a stillbirth at Conway Hospital. She was convicted of homicide by child abuse in 2001 after a jury bought scientifically unsupported arguments that her cocaine use caused the stillbirth. Although McKnight had no prior conviction, and even prosecutors agreed she had no intention of harming the fetus, she was sentenced to 12 years in prison with no chance of parole.

McKnight unsuccessfully appealed her conviction in 2002, challenging the constitutionality of using murder statutes to prosecute women who experience stillbirths. But in a split decision, the state Supreme Court upheld her conviction, offering a novel interpretation of the state's homicide laws. The court held that any woman who unintentionally heightens the risk of a stillbirth could be found guilty of homicide with "extreme indifference to human life." Under this doctrine, the court held, any pregnant woman who engages in activity "potentially fatal" to her fetus could be charged with murder.

McKnight and her attorneys appealed to the US Supreme Court, but that body declined to review the decision.

In Monday's decision, the state Supreme Court focused on whether McKnight got a fair trial. It found that she did not. McKnight's trial counsel, an overworked public defender, was "ineffective in her preparation of McKnight's defense through expert testimony and cross-examination," the court found. The court also found that the information given to the jury about the supposed link between McKnight's cocaine use and her stillbirth was not scientifically supported.

"Significantly, the opinion acknowledges that current research simply does not support the assumption that prenatal exposure to cocaine results in harm to the fetus, and the opinion makes clear that it is certainly 'no more harmful to a fetus than nicotine use, poor nutrition, lack of prenatal care, or other conditions commonly associated with the urban poor,'" said Susan Dunn, counsel for amicus. "This decision puts prosecutors across the state on notice that they must actually prove that an illegal drug has risked or caused harm -- not simply rely on prejudice and medical misinformation."

"Ms. McKnight is one of more than 500 women in South Carolina who experience stillbirths each year, and in many of those cases, medicine just can't determine the cause," said Brandi Parrish, coordinator of the South Carolina Coalition for Healthy Families. "It is a tragedy that Ms. McKnight has been in prison for nearly eight years for a crime she did not commit. Families in South Carolina are not helped by treating stillbirths as crimes and wasting hundreds of thousands of tax dollars to imprison innocent mothers."

At least 90 women have been prosecuted in South Carolina for stillbirths after using drugs, according to National Advocates for Pregnant Women, one of a number of organizations that got involved in the case when McKnight sought redress. "The groups got involved because there is complete consensus that prosecuting pregnant women is bad for mothers and babies," said Lynn Paltrow, head of the group. "Regina McKnight was convicted on junk science and was not fairly represented at trial," she told Myrtle Beach Online Tuesday.

McKnight is not out of the woods yet. Her case has been remanded for retrial, but prosecutors have so far given no indication whether they will proceed. In the meantime, she remains in prison awaiting a hearing on bail pending her new trial.