In examining this dilemma and the developing role of law and criminal justice regarding the rights of newborns and pregnant mothers, the article discusses the effects of illegal drugs on fetuses, the punishment of improper maternal behavior, and predominant arguments for and against the prosecution of mothers. The authors note that the social, physical, and economic costs of drug use by expectant mothers are significant and that punitive action against pregnant women who abuse drugs represents a response to society's increasing frustration with the escalating drug problem. Questions associated with the prosecution of pregnant women who use drugs include whether such criminalization discriminates against lower-class and minority women, whether compulsory drug screening of newborns and reporting of positive findings results in forced detective behavior by medical personnel, whether reporting laws discourage many pregnant women from seeking medical treatment, and whether the threat of prosecution creates an adversarial environment between mother and fetus. Alternatives to punishment in dealing with the problem appear to be few in number and controversial, and an integrated medical, public health, law enforcement, and educational policy has yet to be developed. Future research should examine whether the availability of drug treatment centers and indiscriminate assistance results in opportunities for addicted expectant mothers to stop using drugs. 78 references and 15 notes