What can be done to protect the unborn child of a mother who is drinking?

The answers range from education to counseling, treatment to jail.

On the Fort Peck Indian Reservation, tribal officials are working on plans for involuntary treatment.

"It's not against the law for women to drink, so we can't incarcerate them," said Gary James Melbourne, director of the Fort Peck Tribal Health Department.

"But it's a very serious ethical and moral issue," he said.

Melbourne said about 80 children and young adults on the reservation have been diagnosed with fetal alcohol syndrome, at a cost for custodial care estimated at $20,000 to $24,000 a year each.

Treatment is the answer, he said.

Melbourne said the DUI Task Force, which he heads, is drafting tribal legislation to provide involuntary treatment for pregnant juveniles at the Spotted Wood Treatment Center.

And he said similar legislation for adults will be proposed as soon as an acceptable treatment center is in place.

"If you don't have anything in code to protect a fetus, you have nothing to charge a drinking mother with," he explained.

"But I don't want to go into the next millennium with these types of statistics," he added. "I want to turn this around, but it will require us to provide a treatment center first."

Montana state officials can recommend strategies to prevent fetal alcohol abuse, but there's nothing in state law to force a pregnant mother to stop drinking.

State law does allow a judge to order treatment of an alcoholic who harms or threatens to harm another, but state health officials said there has been no precedent yet allowing them to intervene on behalf of an unborn baby.

"They should throw these women in jail and make them get four or five months treatment, no question about it," insisted Dr. Lucy Reifel, a physician on the Rosebud Sioux Indian Reservation who adopted a child with FAS.

Last year, South Dakota became the first state in the nation to pass legislation allowing judges to order drinking mothers-to-be committed to centers for treatment.

One law allows judges to confine pregnant women in detox centers. Another allows them to require up to nine months of involuntary treatment. A third makes drinking while pregnant a form of child abuse.

Harsher measures have been imposed in other places.

On the Fort Belknap Reservation, drinking while pregnant constitutes child abuse, which is a jailable offense, said Maza Weya, the reservation's FAS coordinator.

In North Dakota, several drinking mothers-to-be were charged with assaulting their unborn children and jailed, but "their convictions were overturned by state and federal courts," said Dr. Robin A. LaDue, a clinical psychologist with the University of Washington's fetal alcohol unit.

In a policy statement, the American Society of Addiction Medicine said jail isn't the answer.

"Criminal prosecution of chemically dependent women will have the overall result of deterring such women from seeking prenatal care and chemical dependency treatment, thus increasing rather than preventing harm to children and to society as a whole," it said.

Instead, it recommended programs to educate women about the dangers of alcohol and counselors to assist them in staying sober.

"Several reservations have fetal alcohol syndrome coordinators who can give women the education and support that they need," said Carlene Red Dog, who held that position on the Fort Peck Indian Reservation before moving to Bakersfield, Calif., to work with the Kern County Health Department.

"If a woman is afraid of going to jail she's going to stay out of the way of everyone who could be of help to her," Red Dog said.