Babies exposed to cocaine in the womb have a 25 percent increased chance of being born premature. An official website of the State of Georgia. An official website of the State of Georgia. These same legislators would be hard-pressed to take babies away from mothers who were struggling with medical treatment for hypertension or diabetes. Ct. App. Meanwhile, several states have expanded their civil child-welfare requirements to include prenatal substance use, so that prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect. The Maternal Substance Abuse and ChildDevelopment (MSACD) Project focuses on theprevention of negative consequences of a maternalsubstance use through a variety of services. However, in 2015, law enforcement cracked down on drug use during pregnancy. What if a pregnant woman drives over the speed limit, or as a matter of vanity doesn't wear the prescription lenses she knows she needs to see the dangers of the road? Her infant tested positive for cocaine shortly after birth. Katie Jane Fernelius Unless otherwise noted, you can republish our stories for free if you follow these rules. To learn about CDC activities to prevent fetal alcohol spectrum disorders, visit About Us from the National Center on Birth Defects and Developmental Disabilities. Some policymakers and law enforcement officials argue that criminal punishment deters substance use among pregnant women.1,,3 In contrast, the medical model of addiction views substance use disorders as chronic, relapsing diseases, with substance abuse during pregnancy an unfortunate, but common occurrence. Three courts stated that permitting prosecutions under the contested statute was counterproductive to state policy goals and public health. Cases of Women Charged With Child AbuseRelated Crimes for Substance Use During Pregnancy, The substances related to the charges were cocaine (n = 15), methamphetamine (n = 10), heroin (n = 2), marijuana (n = 1), oxycodone (n = 1), and unspecified prescription pills (n = 1). We examined only published cases, almost all of which were appellate level decisions. CDC twenty four seven. Many advocates I interviewed in the course of my own research on this subject described the surveillance of pregnancies and non-consensual drug testing performed on pregnant women and their newborns as comparable to stop-and-frisks for young men of color. M. thought she was doing the right thing. First, they say the developing fetus and newborn will be harmed by prenatal exposure to illicit substances. Federal agencies collaborate with both state and local law enforcement to ensure effective controls over substances that are deemed to be a danger to individuals and to society. To view abstracts of recent publications in PubMed, see Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age and Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. Arizona also has the strictest TANF timeline in the nation, kicking families off welfare after one year. Studies show when a pregnant woman uses illegal drugs during pregnancy it can result in miscarriage, low birth weight, premature labor, placental abruption, seizures, respiratory problems, feeding difficulties, and death of the baby and the mother. They help us to know which pages are the most and least popular and see how visitors move around the site. State laws vary, but at least 23 states and the District of Columbia articulate that substance use during pregnancy is child abuse, and virtually every state in the U.S. will open an investigation (at the very least) into a person who tests positive for substances during or shortly after pregnancy. Significantly higher numbers come from the Centers for Disease Control, which in 2019 reported that some 16% of pregnant women . 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. It found that parents face long wait lists when accessing substance use treatment services and often dont have the means to pay. When she visited him, she was distressed to find he often had seemingly untreated rashes. 2023 Guttmacher Institute. 2006), State v. Wade, 232 S.W.3d 663, 665 (Mo. 25states and the District of Columbia require health care professionals to report suspected prenatal drug use, and 8states require them to test for prenatal drug exposure if they suspect drug use. The effects of illegal drugs, such as cocaine, can be devastating on a fetus. Illegal drugs in pregnancy. Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. Fetal or infant toxicology was reported in 24 of the pregnancies, and included positive findings for cocaine (n = 13), heroin (n = 1), and methamphetamine (n = 8) and one case wherein testing was negative for the relevant drug oxycodone, but the infant nonetheless displayed signs of withdrawal.31. [Ref. The Tips campaign features information about how smoking and secondhand smoking affect specific groups, including pregnant women or women planning to have a baby. How you know. 1992), Johnson v. State, 602 So.2d 1288 (Fla. 1992), State v. Gray, 584 N.E.2d 710 (Ohio 1992), Commonwealth v. Welch, 864 S.W.2d 280, 283 (Ky. 1993), Sheriff, Washoe County, Nevada v. Encoe, 885 P.2d 596 (Nev. 1994), Collins v. State, 890 S.W.2d 893 (Tex. Additional cases were identified by reviewing the cases cited in the initial set of cases and published literature, yielding an additional nine cases. The search yielded 77 published cases, of which, on closer review, 16 were found to be relevant. In the medical model, treatment, not punishment, is the remedy to reduce consumption of substances during pregnancy.4 Medical and public health experts are widely opposed to efforts to criminalize substance use by pregnant women.5,,8, Reflecting societal uncertainty about the best approach, legal penalties for substance use during pregnancy because of harm to the fetus or child vary significantly among the states. Criminal or civil penalties discourage women from seeking prenatal care they need for fear of having their drug use discovered, critics say. The vast majority ofTemporary Assistance for Needy Families (TANF) funding, or federal welfare dollars meant to help the poor, is not spent on assistance to poor families, but rather on placing and keeping children in the foster care system. Drugs with evidence of fetal harm were widely used. Experts recognize that pregnancy and childbirth present an especially opportune moment to connect a woman with services, including substance use disorder treatmentyet threats of punishment onlyisolatepregnant women. Cases were decided by state supreme courts (n = 15) and state courts of appeals (n = 14). This evolution over time may reflect contemporaneous moral panic linked to the potential deleterious effects of particular substances on fetal outcomes.1. (3) 31]. Stopping your medication suddenly could be harmful for you and your baby. There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. In the subsequent months, M. saw her son once a week at best. remove barriers to pregnant women with substance use disorders from getting evidence-based treatment that's tailored to their unique needs. Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. These cookies may also be used for advertising purposes by these third parties. Opioid use disorder among pregnant women is a significant public health concern in the United States. MAT is the standard of care for treating people with opioid use disorder especially pregnant women, as quitting opioids too suddenly during pregnancy can result in complications. You can also call 1-800-QUIT-NOW (1-800-784-8669) for free support. Cocaine lingers in a fetus much longer than an adult and often 5-7 days after birth. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. 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. And the scientific literature that suggests that substance use produces social cognitive deficits in parenting is in its infancy and rather underwhelming. CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. At least two states, Arizona and Kentucky, have just made it easier to terminate the rights of mothers who use controlled substances while pregnant. Getty Creative. 2015), The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida, Substance use during pregnancy and postnatal outcomes, Punishing pregnant drug users: enhancing the flight from care, Women's perspectives on screening for alcohol and drug use in prenatal care, Drug use and limited prenatal care: an examination of responsible barriers, Universal screening for alcohol and drug use and racial disparities in child protective services reporting, The American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women and American Society of Addiction Medicine, Committee Opinion No 524. Several leading medical organizations opposed the legislation and cautioned that it would have a negative public health effect of scaring women away from seeking medical help. 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. 2005), Kilmon v. State, 905 A.2d 306, 314 (Md. A total of 24 published judicial opinions met the inclusion criteria (Table 1). Yet despite the country's best efforts to fight it, the problem is getting worse, and is exacerbated by the COVID-19 pandemic. In three of the cases in which medical expert testimony was referenced, the expert testimony was contradictory. Many substance use treatment services dont accept pregnant women, or are otherwiseinaccessibleto them, despitefederalandstateregulations that require prioritizing them for treatment. Using illegal or street drugs during pregnancy, including cannabis, ecstasy, cocaine and heroin, can have a potentially serious effect on your unborn baby. In other instances, where medical expertise was referenced, it did not necessarily support the defendants' position. Despite a lack of criminal statutes specifically targeting substance use by pregnant women in other states, women have been charged and, infrequently, convicted of a range of criminal offenses for illicit substance use while pregnant, including child abuse, assault, manslaughter, and murder.15 In two states, South Carolina and Alabama, these convictions have been upheld by the state supreme court.16,,18 The effect of these rulings is to permit women to be convicted for substance use during pregnancy under existing laws that are not specific to pregnancy. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. 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. You should also speak to your GP, midwife or a drug support service if you're regularly taking prescribed medicines. The groups listed below help people with drug abuse. In Kilmon v. State, the court said, The substances being abused during pregnancy can include alcohol, cocaine, heroin, and opioid addiction. Drug abuse has a long and storied history in the United States, and we've been "at war" with it since 1971 under the Nixon administration. Additional factors were relevant to the stated judicial rationale in at least some of the cases. The pregnancies had the following outcome: no adverse effects of the substance reported (n = 12), withdrawal symptoms (n = 7), prematurity and/or small size at birth (n = 5), death in the neonatal period (n = 3), and stillbirth (n = 2). Future professional advocacy efforts may be most beneficial when directed at state legislatures that are dealing with proposed statutes that address these questions. Kentucky similarly struggles with poverty, poor access to substance use treatment services, and a child protective system that spends more resources on placing children in foster care than keeping them with their families. At the present time, the Center for MSACD fulfills several roles in Georgia by sponsoring clinical, prevention, and research programs. Approximately 700 women in the United States die every year . 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. The mother was a drug addict. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby. We also were unable to determine the race or economic status of the defendants and do not know if poor or minority women are overrepresented among the defendants. Stakeholders should ensure safe prescribing practice for pregnant women through developin Comparisons of drug laws to alcohol laws show that the policy trajectories started in opposite directions, but by 2016, the results were the same: Punitive policies were more prevalent than supportive policies across states. 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. We do not capture any email address. The overwhelming majority of parents prosecuted by the child welfare system are poor, and parents ofcolorare overrepresented. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. 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. A neonatologist who was an expert witness for the defense testified that the cocaine derivatives present in the children's urine were from exchange between the womb and placenta during pregnancy and that only a tiny amount of cocaine derivative could have passed through the umbilical cord during the 30- to 60-second period after the child was born and before the umbilical cord was cut. Arizona now has one of the highest foster care placement rates in the nation. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. Enter multiple addresses on separate lines or separate them with commas. The discourse about criminalization of substance use in pregnancy suggests that women are at serious risk of successful prosecution for illicit drug use during pregnancy.8,15 Based on our review of published judicial decisions, this does not appear to be the case in most jurisdictions. 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. The use of tobacco and alcohol are common (these are discussed in Sections 12 and 13) but the use of illicit substances and the misuse of prescription medications is also important. LEXIS 496 (Tenn. Crim. This was lower than the rate among women in this age group who were not pregnant (11.4 percent). Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Keywords: laws, policies, substance use, care, treatment, infants, neglect Created Date: 8/17/2022 9:48:14 PM All types of alcohol are equally harmful, including all wines and beer. These unintended consequences include keeping women from getting the treatment they need and failing to reduce the number of babies addicted to drugs. 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. In Alabama and South Carolina, high courts have interpreted existing child endangerment and chemical endangerment statutes to allow prosecution of drug-using pregnant women and new mothers. In the 22 judicial opinions wherein charges were dismissed or convictions overturned, all held that the legislature did not intend to include fetuses in the definition of a child or victim in the relevant statute. Such information can assist in making diagnosis of neonatal abstinence syndrome (NAS), as well as help clinicians focus the plan for treatment and follow-up for the neonates. State Policies on Substance Use During Pregnancy. They have 1 child together that was born prematurely due to her drug use. Tobacco and alcohol are the most commonly abused substances, followed by marijuana and cocaine. 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. We did not examine judicial decisions regarding women who have faced civil child abuse proceedings related to prenatal substance use. In the family court systems, there is no respect for medicine or science, she wrote. Prescription Opioid Pain Reliever Use During Pregnancy, The US Opioid Crisis & Maternal Infant Health, Centers for Disease Control and Prevention. Drug use during pregnancy is a severe problem worldwide because it exposes not only the woman but also her developing baby to harmful substances. 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. In jurisdictions where criminal charges are permitted, dispositions for convicted women should be treatment oriented. Support a worker-led Appeal. Quitline coaches can answer questions, help you develop a quit plan, and provide support. More and more states are adopting drug testing for newborns because of the recent increase in opioid use . Heavy use of marijuana - that is, marijuana with high amounts of THC - has been linked to decreased fertility in both men and women. Every pregnant woman facing substance use disorder deserves to get the help she needs so that she and her infant have the best possible chance to thrive. 297 (N.C. 2015), Arrests of and forced interventions on pregnant women in the United States, 19732005: implications for women's legal status and public health, State v. McKnight, 352 S.C. 635, 647 (S.C. 2003), Ankrom v. State, 152 So.3d 397, 411 (Ala. 2013), Moral and social issues regarding pregnant women who use and abuse drugs, A gap in the criminal justice system, creating a new class of felons in pregnant drug-addicted women, a state-by-state analysis, Prosecution of illicit drug use during pregnancy: Crystal Ferguson v. City of Charleston, From the Office of the General Counsel. This conclusion should not be a surprise, given that appellate decisions are based on interpretation of law, not facts. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. But, for that matter, she could have been a pregnant alcoholic, causing fetal alcohol syndrome; or she could have been addicted to self abuse by smoking, or by abusing prescription painkillers, or over-the-counter medicine; or for that matter she could have been addicted to downhill skiing or some other sport creating serious risk of prenatal injury, risk which the mother wantonly disregarded as a matter of self-indulgence. In females, there is evidence that marijuana use may disrupt the menstrual cycle. 1. 2006), State v. Martinez, 137 P.3d 1195, 1198 (N.M. Ct. App. These may include the medical model of substance use disorders,4 racial disparities in substance use screening and reporting in pregnancy,47 and the difficulty of attributing a particular birth outcome to a single cause.48, Criminalization of pregnant women for substance abuse is fraught with problems related to conceptual and practical implementation, even if in theory one believes that substance use in pregnancy is both a moral dilemma and a medical problem. Such laws may discourage people from seeking prenatal care. However, fentanyl has also been manufactured illicitly, and its distribution is on the rise. Thus, it is not clear whether racial or economic bias is a factor in these cases. Hair has been recognized as a possible alternate test specimen, but wider acceptance of hair testing must await .
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