Millions of women use drugs when they’re pregnant. Some are punished when their pregnancies end with a miscarriage or stillbirth, or even when they give birth to a healthy baby. No one knows more about this than Lynn Paltrow, founder and executive director of National Advocates for Pregnant Women (NAPW). We discussed the scientific evidence regarding pregnancy and drug use, the media coverage, and the myths that abound – about “crack babies,” “meth babies” and “oxytots.” Not surprisingly, issues of class and race play a pivotal role not just in determining which women are drug tested and sanctioned but also in popular perceptions of who is to blame and what should be done. Lynn and her colleagues have been at the forefront in defending the rights of pregnant women, and hearing about this important work made for a fascinating and at times heartbreaking conversation.