Just 26 minutes after she was born, Zreanna was pronounced dead, poisoned by the alcohol her mother drank that day.

Now her mother, Sherri Lohnstein, may avoid a seven-year prison sentence if she completes substance abuse treatment programs.

Her doctor thinks she got off easy, while some treatment experts say it was the right sentence because the emphasis should be on getting her help.

Lohnstein told a nurse she thought a few drinks wouldn't hurt.

She smelled of alcohol during one checkup, and her blood-alcohol level registered 0.22 percent. In Missouri, a driver is considered legally drunk at 0.08 percent.

She was also drunk the day she gave birth, with a blood-alcohol level of 0.18 percent. Her daughter was born several weeks prematurely on Sept. 9, 2006, with a blood-alcohol level of 0.17 percent, and died of acute intoxication.

Lohnstein, 34, of Lincoln County, pleaded guilty last week in St. Charles County Circuit Court to involuntary manslaughter and was sentenced to four months in a substance abuse treatment program in the Missouri Department of Corrections.

"It's very frustrating," said Paul Tapia, the doctor who delivered Zreanna and had told Lohnstein to stop drinking while pregnant. "I think the help is there; I think that people don't utilize it. I just feel bad for the children. ... They aren't even born yet and they are already getting abused.

"I think she got away with it. This is a case where the baby died because of what she did. I think four months is nothing."

But some experts and counselors applauded the treatment, saying help rather than hard time was important for Lohnstein, who would still be young enough to become pregnant after a seven-year sentence and put another baby at risk.

"The emphasis should be on prevention, getting women to understand the dangers and if they can't stop drinking, how to get help," said Melinda Ohlemiller, director of prevention services at St. Louis Arc, an agency that helps those with developmental disabilities, including fetal alcohol syndrome.

For women such as Lohnstein, the shame of using drugs or alcohol while carrying a child or fear of going to jail can often prevent them from seeking treatment, experts say.

Some pregnant women might inquire about treatment, not mention that they are pregnant, and hear that a treatment center is full. But the law says that if a clinic takes federal funding, a pregnant woman moves to the top of the center's priority list, said Ohlemiller, who also is an advisory board member for a federal initiative devoted to preventing and treating fetal alcohol disorders.

FIGHTING ADDICTION

Overcoming the disease can be a long road. Dr. Mark Willenbring, the director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism, said that a year after completing a treatment program, about a third of alcoholics are sober or have a drink occasionally without problems. An additional 40 percent are substantially improved but still drink heavily on occasion; and a quarter have completely relapsed.

The Centers for Disease Control and Prevention says that fetal alcohol syndrome rates range from 0.2 to 1.5 for each 1,000 live births annually in the United States. The number of babies that die each year and have alcohol in their systems when they are born is difficult to track because not all are tested for alcohol.

By far, alcohol produces the most serious neurobehavioral effects on a fetus of all substance abuse, including cocaine, heroin and marijuana, according to the National Council on Alcoholism & Drug Abuse.

So far this year, all 38 babies born to women in the treatment program at the Queen of Peace Center in St. Louis were born drug- and alcohol-free. The center provides extended residential and outpatient drug and alcohol treatment for women and their children.

"We believe in saving lives," Executive Director Connie Neumann said. "If (Lohnstein) would have called from Foley, we would have found a way to get her here."

One 31-year-old woman in the program, who was addicted to heroin when she found out she was pregnant, said the program had kept her clean since entering in September. Her baby is due in April.

"If it wasn't for this place, I don't know where I would be," said Erica, who asked that only her first name be used. "Addiction isn't about willpower. It's a disease, and drugs aren't easy for anybody to stop if you are alone and don't have the tools to help you."

ADMITTING GUILT

As part of Lohnstein's sentence, she was required to enter an inpatient program last week at Bridgeway Counseling Services before going to the treatment program in prison in February. If she completes that program, a judge can place her on probation, but she also will have to complete drug court, a program that monitors defendants to help them kick addictions.

Zreanna's father, James Harrison, said Lohnstein shouldn't have to go to prison to do her treatment.

"I think she's already done her time," Harrison said. He declined to comment further.

Lohnstein spent about six months in jail while waiting for her case to be resolved.

Her attorney, public defender Richard Scheibe, said other women who were pregnant and addicted might see her sentence as a confirmation of their fears.

"In their eyes, they'll see it mostly as going to prison rather than getting treatment," Scheibe said. "The next time there is a story about a baby in a Dumpster, I fear we don't really have to wonder why the mother didn't go in and get help."

St. Charles County Prosecutor Jack Banas said that Lohnstein had to admit what she did was wrong and that she had a problem, as part of the sentence.

"It's a far step to say she got away with it," Banas said. "If she completes the program and gets probation, that probation is not going to be an easy probation. You can give people the opportunities; it's up to them to take advantage of those tools."

jbock@post-dispatch.com | 636-255-7208