By Donna Lieberman and Miriam Spiro The conviction of Tabitha Walrond of criminally negligent homicide for the tragic death of her infant son is disturbing. The real culprits -- the Medicaid bureaucracy and the health care system -- were never even indicted, let alone investigated. By all accounts, the 19-year-old mother failed to grasp the severity of her son's condition and failed to surmount the obstacles that kept her from getting her son the medical care he so desperately needed. But the Medicaid bureaucracy and an indifferent delivery system are at least as culpable; they have the expertise and could not have pled ignorance had they been put on the stand. Ms. Walrond's efforts to get treatment for her son were stymied at every turn. The "experts" upon whom the then 19-year old relied for her own care never advised her that her prior breast reduction surgery made breast feeding risky for her baby; nor did they adequately educate her about neonatal growth and the importance of frequent pediatric check-ups during a baby's first months. Moreover, the Medicaid bureaucracy simply would not give her baby the check-ups he so desperately needed until every piece of documentation was in place and the Medicaid card was in hand -- even though every baby born to every mother on Medicaid is automatically eligible for Medicaid. Whether or not justice was done in the Walrond case, justice in the larger sense requires that the obstacles be eliminated. It is time we ensure access to medical care. If a mother is enrolled in Medicaid, her newborn baby should be automatically enrolled. New mothers and their infants should not be ground through the bureaucratic mill that killed Tyler Walrond. Finally, prosecution tactics in this case sent a disturbing message about abortion and breastfeeding. Walrond's consideration of her constitutionally protected right to get an abortion early in the pregnancy was inappropriately introduced as evidence of intent to kill her baby. Fortunately, the jury recognized that it would have been unjust to condemn a teenage mother for weighing all her legal options during pregnancy. Unfortunately, however, the Walrond verdict sends the wrong message that it unsuccessful breastfeeding is a crime. It is now up to health officials to educate the public that breastfeeding is generally healthiest for newborns. The medical establishment must also make sure that breastfeeding -- the benefits and potential problems -- are an integral component of perinatal care. The authors, both lawyers, are the director and counsel to the Reproductive Rights Project of the New York Civil Liberties Union

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