Drug addiction is a serious problem, especially when the drug addict is pregnant. More concerning, limited evidence suggests that punitive polices may deter women from prenatal care.49,,51 These policies also disproportionately affect minority and poor women.15,52 For example, in one study, black women who tested positive for substances at birth were reported to authorities at about 10 times the rate of white women, despite similar rates of substance use.47 Advocates of the punitive approach assert that drug courts can be used to compel treatment for pregnant women with substance use disorders. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Some research shows that marijuana use during pregnancy is linked to health concerns, including high use of other substances that may impact pregnancy and infant health such as tobacco, and developmental problems in adolescents. Using illegal drugs while pregnant can cause many complications to the baby including brain damage, premature birth, low birth weight and even fetal death. The Center for MSACD also provides training, workshops, and other informational services concerning prenatal exposure to alcohol, nicotine, illicit drugs, and prescription drugs. Tennessee is the only state that has enacted a law that targets substance use by pregnant women on the basis of presumed harm to the fetus or child. It is, however, not known how many women, if any, have been convicted at the trial court level and not had their case heard at the appellate level. At least two states, Arizona and Kentucky, have just made it easier to terminate the rights of mothers who use controlled substances while pregnant. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. " Among pregnant women aged 15 to 44, 5.4 percent were current illicit drug users based on data averaged across 2012 and 2013. 1. Three courts stated that permitting prosecutions under the contested statute was counterproductive to state policy goals and public health. Sign In to Email Alerts with your Email Address. -- A Tennessee woman is the first to be charged under a new state law that specifically makes it a crime to take drugs while pregnant . 488. first criminal charges brought against a woman for using drugs during pregnancy came in 1977 against Margaret Reyes. Supporters of these laws blame the mothers for the dissolution of their families, arguing that the mothers need only enroll in a drug treatment program to retain custody of their children. Twelve opinions noted that other jurisdictions ruled similarly when faced with such cases. It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. 19 stateshave either created or funded drug treatment programs specifically targeted to those who are pregnant, and 17 states and the District of Columbia provide pregnant people with priority access to state-funded drug treatment programs. When she visited him, she was distressed to find he often had seemingly untreated rashes. Additionally, e-cigarettes and other tobacco products containing nicotine (the addictive drug found in tobacco) are not safe to use during pregnancy. Prevalence of Current Substance Use Among Pregnant People in the US. You can also call 1-800-QUIT-NOW (1-800-784-8669) for free support. MSACD collaborates with Georgias Alcohol Prevention Providers and their communities in all six of Georgias regions to raise awareness about alcohol and substance abuse among pregnant women. Rapidly detecting fetal exposure to licit and illicit drugs is of considerable medical value. Abstract. Additional cases were identified by reviewing the cases cited in the initial set of cases and published literature, yielding an additional nine cases. Between 1992 and 1995, the number of states that prosecuted drug-addicted pregnant women increased nearly threefold. Contributions are tax deductible to the fullest extent allowable. Neonatal exposure to some drugs during pregnancy can have harmful effects on development and may lead to acute adverse events, including neonatal abstinence syndrome (NAS) and infant mortality. However, fentanyl has also been manufactured illicitly, and its distribution is on the rise. The Tips campaign features information about how smoking and secondhand smoking affect specific groups, including pregnant women or women planning to have a baby. The underlying legal question considered in the judicial decisions in these cases is whether, for the purpose of adjudicating the criminal charges, a fetus is a child. Although pregnancy is an exciting time, there are stresses and risks that come with pregnancy and the postpartum period. The report also found that Kentuckys child protection agency was not making enough efforts to prevent removal or re-entry to foster care. As of last year, they were still apart, and M. has since lost touch with her lawyer. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. Psychiatrists should be involved with drug treatment courts to ensure that any court-compelled treatment meets the complex medical and psychosocial needs of pregnant women with substance use disorders. Similarly, in Ankrom v. State, the state supreme court found that the plain meaning of the word child is broad enough to encompass all childrenborn and unborn.18 When fetuses are included in the definition of child, the child abuse statutes are then found to be applicable to the alleged prenatal conduct. A recent addition to the Center is Mother To Baby Georgia, a service providing evidence-based information to women about exposures to medications and other substances during pregnancy. Although this may be the case, the medical care mandated by many drug treatment courts falls well below the standard of care required for some pregnant women.53,54, Of note, the cases loosely reflect epidemiological trends in patterns of drugs of choice. There were over 100,000 drug overdose . In 2014, Tennessee became the first (and only) state to pass a law that criminalized drug use during pregnancy, after a district court judge added an additional six years to the prison sentence of a woman who had been involved in a methamphetamine manufacturing operation while pregnant. In three states Minnesota, South Dakota and Wisconsin women who use drugs during pregnancy can be involuntarily committed to a treatment program. Ct. App. Arizonaslegislation, which became law in April, permits termination of a mothers parental rights, either immediately when her newborn is born or within one year of her newborns birth, depending on how chronic the illicit drug use appears to the court. The state argued that the drug delivery occurred via the umbilical cord in the period after birth but before the cord was clamped. App. Among pregnant women aged 15 to 44, the average . Prescription opioids may be prescribed by doctors to manage moderate to severe pain. With the U.S. Supreme Court considering a high-profile case involving the prosecution of pregnant substance abusers, policymakers and advocates once again are confronted with the decade-old question of how best to deal with pregnant women who use drugs. 24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes, and 3 consider it grounds for civil commitment. We reviewed legal decisions regarding women charged with a crime against a fetus or child as a result of substance use during pregnancy. Many substance use treatment services dont accept pregnant women, or are otherwiseinaccessibleto them, despitefederalandstateregulations that require prioritizing them for treatment. The infant was born prematurely. Local, state, and federal government websites often end in .gov. Katie Jane Fernelius Dehumanizing Discourse, Anti-drug Law, and Policy in America: A "Crack Mother's" Nightmare . A new study co-authored by a University of Central Florida researcher shows that laws that punish substance use during pregnancy actually do more harm than good. Many states recognize this as an act of child abuse on the unborn fetus . Since the late 1980s, policymakers have debated the question of how society should deal with the problem of substance use during pregnancy. Another major concern is addressing the harm that a child of any age can \ suffer when a parent's use of alcohol or other substances leads to neglect of the child, or the child is exposed to illegal drug activity. It's best not to stop abruptly without first seeking medical advice as there may be . Hair has been recognized as a possible alternate test specimen, but wider acceptance of hair testing must await . In order to to avoid the risk of withdrawal and possibly harming her fetus, M. did what many pregnant women in her situation do she continued to use illicit opioids. Fetal Assault Laws. Substance abuse reporting and pregnancy: the role of the obstetriciangynecologist, Board of Trustees, American Medical Association, Legal interventions during pregnancy: court-ordered medical treatments and legal penalties for potentially harmful behavior by pregnant women, Tennessee voices: drug use in pregnancy is an epidemic, Prenatal Drug Use/Criminal Offense S.B. The substances being abused during pregnancy can include alcohol, cocaine, heroin, and opioid addiction. In Alabama and South Carolina, the majority of state supreme court judges determined that the plain meaning of the word child includes a fetus, or in their term, an unborn child.16,,18 In the other 17 states that considered the question, the opposite conclusion was reached: that is, a fetus is not a child in the eyes of the law in those jurisdictions. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. If you or someone you know has a drug problem, seek help. Prescribed medicines. You can review and change the way we collect information below. In females, there is evidence that marijuana use may disrupt the menstrual cycle. Pregnancy. And in order to receive federal child abuse prevention funds, states must require health care providers to notify child protective services when the provider cares for an infant affected by illegal substance use. CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. Webster v. Reproductive Health services: the AMA position, Prosecuting pregnant women for drug use during pregnancy: the criminal justice system should step out and the affordable care act should step up, People v. Morabito, 580 N.Y.S.2d 843 (N.Y. City Ct. 1992), Reyes v. Superior Court, 75 Cal. Babies exposed to cocaine in the womb have a 25 percent increased chance of being born premature. At issue is whether the continued drug use of a newborn's mother is tantamount to "child abuse" that would give child protective services workers and law enforcement officers the ability to remove the child from the mother's care - even if the . Women might use opioids as prescribed, misuse prescription opioids, use illicit opioids such as heroin, or use opioids (opioid agonists and/or antagonists) as treatment for opioid use disorder. For example, Amanda Kimbrough's child was born prematurely and died shortly after birth, having tested positive for methamphetamine. Marijuana remains illegal at the federal level, even as some states have legalized it for recreational and medicinal use. Keywords: laws, policies, substance use, care, treatment, infants, neglect Created Date: 8/17/2022 9:48:14 PM The legislators behind these laws are essentially creating a capital offense for women who give birth despite having used an illegal drug, said Erin Miles Cloud, a senior attorney at the Bronx Defenders Family Defense Practice, who has represented numerous parents facing termination of parental rights proceedings. Subscribe to our newsletters for regular updates, analysis and context straight to your email. On June 13, 1997, the governor of Tennessee signed House Bill 1413, making it a Class A misdemeanor for child abuse where: (1) a woman consumes alcohol or illegal drugs during pregnancy with knowledge or the reason to know that such consumption may result in harm to her child; and (2) the child is born addicted to alcohol or drugs. Exact terminology for relevant crimes varies across states and broad inclusion criteria were used for initial case review. These 24 cases included 29 women in 19 states who were prosecuted for criminal charges related to harm to a fetus or child as a result of substance use during pregnancy. Drugs with evidence of fetal harm were widely used. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. For more information, see What You Need to Know About Marijuana Use and Pregnancyand The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (2017). Exposing how the U.S. criminal legal system fails to keep people safe and perpetuates harm. Otherstudieshave found that babies exposed to cocaine in utero perform better on several developmental measures when left with their mothers than do those removed to foster care. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. Four courts noted that allowing a conviction would result in an absurd punishment scheme. NAS is a group of withdrawal symptoms that most commonly occurs in newborns after exposure to opioids during pregnancy.If you are pregnant and using opioid pain medications, CDC recommends you talk to your provider before starting or stopping any medications to help you understand all of the risks and make the safest choice for you and your pregnancy. Criminalization of substance use during pregnancy because of harm to the fetus or child is fiercely debated. Georgia drug possession laws treat the crime very seriously and a conviction for possession of even a small amount of an illegal drug can subject you to serious penalties. While some papers estimate that 1-3% of birth defects are thought to be caused by medications taken during pregnancy, the authors could not find a source for this statement that was based on study d. Later in the pregnancy, these illicit drugs may cause. Intellectual & Developmental Disabilities, Applications for New & Existing Providers, Improving Health Outcomes Initiative Collaborative Learning Center, How to Report a Concern or Complaint about the Quality of Care or Safety, Facebook page for Georgia Department of Behavioral Health and Developmental Disabilities, Twitter page for Georgia Department of Behavioral Health and Developmental Disabilities, Linkedin page for Georgia Department of Behavioral Health and Developmental Disabilities, The Maternal Substance Abuse and ChildDevelopment, Maternal Substance Abuse and Child Development Project. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. The South Carolina Supreme Court held that a viable fetus is a "person" under the state's criminal child-endangerment statute and that "maternal acts endangering or likely to endanger the life, comfort, or health of a viable fetus" constitute criminal child abuse. Before sharing sensitive or personal information, make sure youre on an official state website. Arizona now has one of the highest foster care placement rates in the nation. Drug Use by State: Problem Areas. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. You can also go to SAMHSAs Behavioral Health Treatment Services Locator. One of the authors read six cases in random order, abstracting data into the identified categories of variables to determine the applicability of the a priori coding scheme. Many substance use treatment centers do not offer MAT due to the stigma associated with it, and those centers that do provide MAT have not necessarily fulfilled their responsibility toprioritizepregnant women. Trainings on maternal substance abuse, child development, alcohol and other drug related effects are conducted for prevention providers. Supporters of these laws justify the surveillance, policing, and punishment of drug-using mothers by referencing two assumptions that were touted and then discredited during and after thecrack baby scare. Kentucky ranks amongst the last in the nation in rates ofchildhood poverty. Opioid use disorder among pregnant women is a significant public health concern in the United States. A representative example of this due process reasoning was expressed by the court in State v. Martinez: To expand the ordinary meaning of this statute would deny Defendant reasonable notice that her actions were criminal, thereby violating her due process rights.39 Six courts held that allowing the contested statute to apply to prenatal drug use would in effect permit it to be applied to a range of prenatal conduct not previously considered illegal, in effect opening the floodgates to prosecution of pregnant women. If you or someone close to you needs help for a substance use disorder, talk to your healthcare provider or call SAMHSAs National Helpline at1-800-662-HELP. Collaborations have included media messages on maternal substance abuse during pregnancy and supplying resources addressing the use of any substance. Kansas and Nebraska have no reporting or testing requirements, the survey says. The Wisconsin law is especially draconian: A woman can be detained against her will for the duration of her pregnancy, her fetus has its own court-appointed lawyer, she can lose custody of her baby after birth and the proceedings are mostly secret. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby. Healthy pregnancies are essential for the well-being of mothers, infants, families and communities. 96 A 2017 opinion posted by . The following information can help you understand [] As her due date approached, M. found a hospital that claimed to specialize in the care of babies who were exposed to opioids in utero and traveled a far distance to give birth there. A number of states require health care professionals to report or test for prenatal drug exposure, which can be used as evidence in child-welfare proceedings. The court also referred to rulings by appellate courts in other jurisdictions that had held similarly in comparable cases. App.3d 214 (Cal. Meanwhile, private insurance companies have found ways to circumvent Obamacare requirements on MAT coverage. Using these drugs during pregnancy may affect your baby's growth and puts you at higher risk of miscarriage, early labour, and placental abruption, where the placenta comes away from the wall of the womb . Quitting early or before pregnancy is best, but its never too late to quit smoking. Additional factors were relevant to the stated judicial rationale in at least some of the cases. After the passage of the 2014 law, this reasoning no longer applied, although it became relevant again with the fetal assault law's expiration in July 2016. Those unable to pay may perform community service instead. Temporary Assistance for Needy Families (TANF) funding, The Truth About Marijuana and the Criminal Legal System, Florida Cops Nearly Sent a Five-Year-Old to Jail, When It Comes to Reporting Deaths of Incarcerated People, Most States Break the Law, M. Forrest Behne, Craig Waleed, Meghan Peterson, and Lauren Brinkley-Rubinstein, Gay And Trans Panic Is Still Being Used To Justify Anti-LGBTQ Attacks. Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. M. thought she was doing the right thing. She had given birth approximately one year earlier to a child who had also tested positive for cocaine. In 2005, the Tennessee Court of Appeals overturned convictions based on guilty pleas for aggravated child abuse for methamphetamine use during pregnancy in two cases combined as Richards v. State.37 The judicial reasoning was that the women received ineffective assistance of counsel, in that their attorneys should have argued that their conduct fell outside the scope of the law, which at that time was intended to apply only to conduct that affected children, not fetuses. A drug possession conviction in Georgia also results in the suspension of your driver's license. Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. However, in 2015, law enforcement cracked down on drug use during pregnancy. Although briefs from medical or public health organizations supporting the defendants' position were submitted to the court in 29 percent of the cases (n = 7), only one majority ruling directly referenced a medical or public health organization amicus brief. Only four states (North Dakota, Minnesota, Iowa and Kentucky) require hospitals to test both new mothers and their children if medical professionals suspect drug use. Indeed, Kentucky has one of the highest rates of child removal in the country. Instead of punishing women for the chronic condition of addiction, something that is unethical, ineffective and inhumane, we should invest instead in the expansion of women- and family-friendly treatment resources, said Dr. Mishka Terplan, a professor in obstetrics and gynecology and psychiatry and associate director in addiction medicine at Virginia Commonwealth University.