The woman’s prerecorded voice sounds tired, slightly nasal. “Hello and thank you for caring enough to call Project Prevention. We hope this will be the first of many more responsible decisions you will soon be making,” she says. “We pay for tubal ligations, Essure, Implanon, and IUDs for women, and only vasectomies for men.” She rattles off instructions: speak slowly spelling your name and address, wait for forms and instructions in the mail. As soon as your doctor or clinic verifies that you’ve undergone the procedure and submit arrest records proving past or current addiction, you will receive payment. Among the directives, a warning: “If you want to be paid cash, you do so at your own risk.”
This is (888) 30-CRACK, the hotline for a North Carolina-based nonprofit that offers drug and alcohol addicts $300 to undergo sterilization or adopt long-term birth control. The tired voice belongs to Barbara Harris, 59, who founded the group in 1994 as Children Requiring a Caring Kommunity (CRACK) after she adopted the first of four children from a crack-addicted Los Angeles mother. Now called Project Prevention, the volunteer-run organization operates in major cities nationwide, posting flyers in homeless shelters, clinics, and what Harris calls “drug areas”—usually poor or minority neighborhoods.
One flyer, the kind often stapled to telephone poles, shows a close-up of a scrunchy-faced newborn under the words “She has her daddy’s eyes…and her mommy’s heroin addiction.” Another says, “Don’t let a pregnancy ruin your drug habit”; another, “Get Birth Control, Get Ca$h.” Project Prevention’s controversial advertising has garnered plenty of press—Harris also drives around the country in an RV-cum-mobile billboard papered with pictures of dead infants, razor blades, and lines of crack—including features in Time, The Fix, and on CNN, among others.
Critics of the group have included the National Advocates for Pregnant Women (NAPW), the American Civil Liberties Union, and Planned Parenthood, along with bioethicists and others who claim that Project Prevention targets poor and minority communities. The group has been accused of racism, exploitation, and even of practicing eugenics. Harris brushes off the criticism. She told Time in 2010, “What makes a woman’s right to procreate more important than the right of a child to have a normal life?”
project prevention offers its clients a choice of birth control—addicts can opt for Implanon, a hormonal contraceptive inserted beneath the skin of the upper arm, intra-uterine devices (IUD), or the Depo Provera shot, all of which are temporary. Until recently, the group paid clients only $200 for these procedures, as opposed to $300 for permanent forms of birth control: vasectomies for men and tubal ligations or Essure, a pair of rods inserted into the fallopian tubes, for women. Once the client has called Project Prevention, decided on a method of birth control with their doctor or clinic, and submitted proof of the procedure, they receive payment. Critics like the Committee on Women, Population, and the Environment (CWPE) say the money offer exploits vulnerable men and women and threatens their reproductive choices.
Asked why the group focused its advertising in lower-income neighborhoods, a Chicago Project Prevention volunteer said that the cash “appeals more to the poor than it does to the rich,” making it “more practical to post fliers in areas where poor people live and congregate,” according to a CWPE report. As of last May, Project Prevention had sent checks to all 50 states, with a total of 4,097 paid addicts—1,507 of who had been sterilized.
Accusations of racism have dogged the group since its inception. To date, about 53 percent of Project Prevention’s clients have been white, 24 percent black, and 12 percent Hispanic—numbers that don’t seem to suggest racial targeting. But as NAPW Executive Director Lynn Paltrow pointed out in a 2002 critique, Project Prevention treats a larger proportion of men and women of color, who make up 47 percent of their clientele, than is reflected in the national population, where non-whites comprise about 28 percent, according to the 2010 census.
In response to these claims, Harris often points out that both her husband and four adopted children are black. “If you hear about what we’re doing and just assume that only black women are calling, then that makes you a racist,” Harris told the Independent in a phone interview this week. Before starting Project Prevention, Harris says she maintained an organization for interracial families in the Los Angeles area.
In all, Harris has 10 kids ranging in age from 19 to 40. Harris’s adopted daughter Destiny, 22, has written in support of her mother’s work on the group’s website. Son Isaiah, 21, spent the summer travelling the Southern states in the RV that serves as the group’s touring operation.
“If you’re a drug addict, we’re looking for you, and I don’t care what color you are,” Harris told The Fix last May. “We don’t even know what color your baby will be, because often these babies come out all different colors, you know what I mean? They’re mixed.”
“I think the racist claims are completely unfounded,” said Robert Pugsley, a professor of criminal law at Los Angeles’s Southwestern Law School, in a phone call to the Independent. “It’s the conduct of the person—the addict—not their racial, ethnic, or gender issues. It’s the conduct of the addict and their irresponsibly bringing a child into the world that they cannot care for.”
Yet a video released by NAPW last May suggests that pregnancy can be a positive motivator for addicts to get clean. Harris, however, is dismissive: “It doesn’t matter how many women I offer drug treatment to, if they’re not at that point in their life, they’re not going to do it. Of over 4,000 women, not one has taken me up on it.”
Though pugsley serves as one of several academics on the board of Project Prevention, he doesn’t agree with Harris on all counts. “I don’t believe in criminalizing somebody who is an addict and carrying a child,” said Pugsley. “Not every baby born to an addicted person is going to come out to be a three-headed monster.” In the early 1990s, Harris helped draft the Prenatal Neglect Act, legislation that would have made it a crime to give birth to a child with Fetal Alcohol Syndrome or addiction. It was after that legislation failed that she started CRACK, hoping to fight the problem at its root.
“Those resources we do have are spent to prevent a problem for $300 rather than paying millions after it happens in cost to care for a potentially damaged child,” explains the Project Prevention website. The group’s mission is “to reduce the burden of this social problem on taxpayers, trim down social worker caseloads, and alleviate from our clients the burden of having children that will potentially be taken away.”
This rhetorical emphasis on reducing welfare costs harkens back to the Reagan era, when the rise of social conservatism made the dole a dirty word. “This image of dysfunctional poor families, particularly poor families of color, became a really crucial trope for the conservative anti-welfare movement,” explains historian and Brown Professor Robert Self. “The idea was that these were women who were addicted to crack and had no visible means of support.” Self explains. “I think that fit the larger conservative narrative of pathological women of color living off of the state.”
While Harris says her funding comes from all over the political spectrum, some of her biggest donors include Richard Mellon Scaife’s ultra-conservative Allegheny Foundation and former talk-show host Dr. Laura Schlessinger. “I’ve never had to go and look for money. It’s found me,” said Harris. She says donors like giving to Project Prevention because they see tangible results. “If you donate to a homeless organization, they’re going to always be feeding the homeless. Most agencies that you donate to don’t prevent a problem, they’re just serving a problem. And with us, we take care of it—problem solved.”
“Of all the risks to future children, among the smallest numerically is the use of any illegal drug,” NAPW Executive Director Lynn Paltrow told The Fix in May. “Compared to poverty, lack of access to prenatal care, obesity, cigarette smoking, we’re talking relatively few women.”
Illicit drug use by pregnant women is lower at 5.2 percent than use of alcohol (11.6 percent) or tobacco (16.4 percent), according to the Department of Health and Human Services. And in 2009, the New York Times reported that while “cocaine is undoubtedly bad for the fetus,” its effects “are less severe than those of alcohol and are comparable to those of tobacco.”
Yet Project Prevention stresses the extreme harm done to children of addicts, paying far less attention to the treatment of struggling parents. “There nothing wrong with facilitating people doing things they want to do,” Paltrow told CNN. “What’s wrong is stereotyping a whole group of people and saying…that there’s a class of people who are dangerous by procreating.”
Such critiques echo back to the early twentieth century, when eugenics gained popularity as the idea that certain populations, particularly the non-white and the poor, should not reproduce. Birth control advocate Margaret Sanger was one early supporter, endorsing a combination of breeding techniques and birth control to keep ‘illiterate’ and ‘degenerate’ populations low. “This was all bound up with a whole set of ideas from that era that the ‘lesser races’ were reproducing faster than the ‘superior races,’” explains Self.
From 1907 through the 1930s, 27 states passed compulsory sterilization laws. By 1980, more than 63,000 African Americans, Native Americans, poor, and mentally and physically disabled persons had been forcibly sterilized under official state programs, historian Mark Largent wrote in his 2008 book Breeding Contempt. Oregon was the last state to retire its Eugenics Board, in 1983, with the last forced sterilization occurring in 1981. This summer, North Carolina became the first state to indemnify victims of forced sterilization, offering each survivor $50,000.
Some of Harris’s own language is scarily reminiscent. She has famously compared the women she serves to animals, telling the Telegraph, “We don’t allow dogs to breed. We neuter them. We try to keep them from having unwanted puppies, and yet these women are literally having litters of children.” In a subsequent interview, Harris used the dog metaphor again. “It’s the truth—they don’t just have one and two babies, they have litters.”
For critics like Paltrow, it’s language like this that’s hard to come back from. “You label their kids as damaged—many of whom aren’t—and you label all people who have a variety of drug problems as people who shouldn’t have children,” she told CNN. The problem, Paltrow says, is “the information that [Harris] suggests, that drug users are all irresponsible, they all have damaged babies.”
But Harris’s own family counters that idea. “Most kids aren’t as fortunate as my four,” Harris says. “I have two, Destiny and Isaiah, who are doing great. And I have two who have issues, who are in therapy and on medication. It’s a gamble.”
In 1974, the us district court in the District of Columbia ruled in Reif v. Weinberger that federally assisted sterilizations could only be performed voluntarily and with the full knowledge and consent of the individual. “Even a fully informed individual,” the court wrote in its decision, “cannot make a ‘voluntary’ decision concerning sterilization if he has been subjected to coercion.” Because so many of Project Prevention’s clients lack healthcare, the procedures are often covered by Medicaid. This means the group’s work is legal, so long as the addicts who contract with them make an informed, voluntary decision.
It’s here that Judith M. Scully, Associate Professor at the West Virginia University College of Law, takes issue with Project Prevention. “It is difficult to imagine,” she wrote in a 2000 publication for Hampshire College, “how anyone can honestly claim that informed consent exists in a sterilization scenario where cash incentives are being offered to low-income drug-addicted women.”
While one solution might be for Project Prevention to offer its services for free, Harris is skeptical. “Think about it,” Harris says. “Birth control is already free, so if [addicts] were all going and getting it, we wouldn’t have this problem….Yes, you have to bribe them, or whatever you want to call it, to get them to be responsible. But it’s a win-win for them as well.” For Harris, it comes down to the children. “People say, you know, that then they use their money to buy drugs. They’re going to buy drugs with or without us, and that’s their choice. But the babies don’t have a choice.”
Ellora Vilkin B’14 fills in the gap.