Published on September, 30, 2015. State legislators, law enforcement officials, and physicians have struggled to reach consensus on how to identify, treat, and possibly punish women who abuse illegal substances during pregnancy. Thank you for taking the time to confirm your preferences. These cookies may also be used for advertising purposes by these third parties. Dehumanizing Discourse, Anti-drug Law, and Policy in America: A "Crack Mother's" Nightmare . Substance Abuse During Pregnancy and the Threat of Jail The Center for MSACD also provides training, workshops, and other informational services concerning prenatal exposure to alcohol, nicotine, illicit drugs, and prescription drugs. This means that first-time offenders will be issued an infraction (like a speeding ticket) instead of jail, with a maximum fine of $150. While medication assisted treatment (MAT) is covered under Arizonas newly expanded Medicaid programs, Arizonans still struggle withaccessto MAT treatment. Drugs and Pregnancy - Department of Mental Health 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. Prescription drugs use during pregnancy in Ethiopia: A - PubMed Many of the early cases were related to maternal cocaine use, whereas more recent cases tended to involve maternal methamphetamine use. Laws That Punish Pregnant Drug Abusers Aren't Working, New Study Finds When she visited him, she was distressed to find he often had seemingly untreated rashes. For example, the court held in State v. Gethers that, fear of prosecution could deter pregnant drug abusers from seeking treatment for drug problems.26 Thus, all of the courts whose decisions functionally overturned convictions or dismissed charges did so on the basis of legislative intent, but varied with respect to additional supporting legal arguments. You can review and change the way we collect information below. Cocaine lingers in a fetus much longer than an adult and often 5-7 days after birth. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. In all of the cases, the judicial decision depended on the disposition of the question of whether, for the purpose of adjudicating the criminal charges, a fetus is a child. If youre using marijuana and are pregnant or are planning to become pregnant, talk to your healthcare provider. Cases were decided by state supreme courts (n = 15) and state courts of appeals (n = 14). How Do We Respond to Mothers Who Use Drugs During Pregnancy? Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. The effects of illegal drugs, such as cocaine, can be devastating on a fetus. 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. These same legislators would be hard-pressed to take babies away from mothers who were struggling with medical treatment for hypertension or diabetes. 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. Criminal Charges for Child Harm from Substance Use in Pregnancy, Journal of the American Academy of Psychiatry and the Law Online, Substance and shadow: women and addiction in the United States, Pregnancy and drug use: the dangerous and unequal use of punitive measures, Fetal protection laws: moral panic and the new constitutional battlefront, Clinical, ethical, and legal considerations in pregnant women with opioid abuse, American Academy of Pediatrics Committee on Substance Abuse, Council on Addiction Psychiatry, American Psychiatric Association, Position statement on the care of pregnant and newly delivered women addicts, ACOG Committee Opinion No 473. This claim also disregards the seriousgapsin access to treatment for substance use disorders, especially for poor people, and the absence of a social safety net to even support struggling families in the first place. 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. 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. It often relies on caseworker-confirmed reports of child maltreatment, despite thewell-documentedpropensity of caseworkers and family courts to base findings of child neglect on evidence of drug use alone. 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. 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. Cocaine use during pregnancy poses severe issues for affected babies both short and long-term. 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. 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. Two States Just Made It Easier to Take Babies Away From Mothers Who Use Arizona also has the strictest TANF timeline in the nation, kicking families off welfare after one year. Additionally, in three states, Minnesota, South Dakota, and Wisconsin, women who use drugs during pregnancy can be involuntarily committed to a treatment program. Although the legal bases for appellate court decisions varied (see Table 1), the functional outcome was that the charges were dismissed (n = 14) or convictions overturned (n = 11) for 86.2 percent of the women (25/ 29). Policies That Punish Pregnant Women for Substance Use Don't Help - RAND In females, there is evidence that marijuana use may disrupt the menstrual cycle. 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. App. App. Good reproductive health policy starts with credible research. Kentucky includes drug use during pregnancy as child abuse | Lexington Published on September, 30, 2015 Across the country, hundreds of pregnant women and new mothers have been accused of child abuse or other crimes when they or their newborns tested positive for. Collaborations have included media messages on maternal substance abuse during pregnancy and supplying resources addressing the use of any substance. Hair has been recognized as a possible alternate test specimen, but wider acceptance of hair testing must await . In the subsequent months, M. saw her son once a week at best. Az Law on Drug Use During Pregnancy? A substantial body of legal literature traces the development of case law related to substance use during pregnancy and problems with criminalization of pregnant women.15,19,,23 In this article, we systematically review published legal cases of women charged with offenses causing harm to their fetus or child as a result of substance use during pregnancy, wherein the trial court decision was appealed. Twelve opinions noted that other jurisdictions ruled similarly when faced with such cases. 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. State Responses to Substance Abuse Among Pregnant Women, Concerns Mount over Punitive Approaches to Substance Abuse Among Pregnant Women. 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. More about medicines in pregnancy. 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. 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). It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. At least two states, Arizona and Kentucky, have just made it easier to terminate the rights of mothers who use controlled substances while pregnant. Between 1992 and 1995, the number of states that prosecuted drug-addicted pregnant women increased nearly threefold. The apparent lack of a link between the proscribed conduct and a distinct harm in a large number of the cases is one example of this significant limit to the rationale for criminalization. For the purpose of this review, we identified published legal decisions regarding women criminally charged with a crime against a fetus or child for substance use during pregnancy from appellate level courts. Unless otherwise noted, you can republish our stories for free if you follow these rules. We examined only published cases, almost all of which were appellate level decisions. 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. In 2014, Tennessee made national news when it became the first state in the country to pass a law specifically making it a crime to use drugs while pregnant. Using Illegal Drugs During Pregnancy We conducted a LexisNexis search of published U.S. state and federal cases in these categories using the following search terms: pregnant OR pregnancy AND cocaine OR methadone OR heroin OR controlled substance OR methamphetamine OR narcotic AND child abuse OR child neglect OR child endangerment OR assault OR homicide OR murder OR manslaughter. Briefs from medical or public health organizations were submitted to the court in seven of the cases, all supporting the defendant's position. Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. 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). Indeed, few, if any, middle- or upper-class women who use drugs during pregnancy will ever experience a child abuse and neglect proceeding, let alone a termination of parental rightsthough drug use is common among people of all socioeconomic levels. Under states child abuse law, a parent is considered unfit if they test positive for substances within eight hours after delivery and have previously been convicted of child abuse or neglect or if they failed to complete a drug treatment program recommended by Child Protective Services. One local news source investigated Poolaw's case in conjunction with 45 other pregnant women across the state charged with felony child abuse, neglect, or manslaughter in relation with substance use since 2017. 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. To learn about CDC activities to prevent fetal alcohol spectrum disorders, visit About Us from the National Center on Birth Defects and Developmental Disabilities. Criminal Charges for Child Harm from Substance Use in Pregnancy Urine screening remains the most commonly used method despite the limited period during which drugs can be detected. Kansas and Nebraska have no reporting or testing requirements, the survey says. Ct. App. Many states recognize this as an act of child abuse on the unborn fetus . Prosecutors have attempted to rely on a host of criminal laws already on the books to attack prenatal substance use. Substance Use During Pregnancy | Guttmacher Institute Since the late 1980s, policymakers have debated the question of how society should deal with the problem of substance use during pregnancy. The use of prescription drugs during pregnancy, excluding supplements, in Ethiopia was high. This means that a woman who uses opiates during pregnancy may be prosecuted if her child shows any signs of harm (including neonatal withdrawal) related to the use of opiates. [Ref. The new requirements become effective on July 1, 2007 To learn about CDC activities to educate the public about the harms of tobacco use, visit Tips From Former Smokers (Tips) from the Office on Smoking and Health. The search yielded 77 published cases, of which, on closer review, 16 were found to be relevant. The city of Savannah decriminalized the possession of marijuana, effective July 1, 2018. Drug Use by State: Problem Areas - WalletHub Support a worker-led Appeal. Substance Abuse Reporting and Pregnancy: The Role of the - ACOG Illegal or recreational drugs and pregnancy | Tommy's LEXIS 496 (Tenn. Crim. The state legislature passed the law in 2014 explicitly to permit criminal assault charges for illicit substance use in pregnancy and, on conviction, imprisonment.10 The impetus for the law was rapidly rising rates of neonatal abstinence syndrome, an opioid withdrawal syndrome in infants that may require prolonged monitoring in intensive care units.12 The law expired on July 1, 2016, based on a sunset provision in the original bill.10 No other states have similar criminal statutes, but two other state legislatures recently debated criminalization to combat the opioid epidemic.13,14. Through these efforts, the Center for MSACD continues to be a valuable resource to individuals, parents, and professionals in Georgia and the Southeast. 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. If you or someone you know has a drug problem, seek help. 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. State Laws Punish Pregnant People Just For Seeking Drug Treatment 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Medical and public health experts who are desirous of seeing a greater focus on treatment of substance-abusing pregnant women must stay particularly alert to legislative efforts to expand the legal definition of a child to include fetuses or to define prenatal substance use explicitly as a form of child abuse. So the very condition that Kentucky believes should trigger fast-tracked termination of parental rights is in fact often most effectively treated by close, consistent contact between the mother and newborn. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . Opioid use disorder is a problematic pattern of opioid use that can result in health problems, disability, or failure to meet major responsibilities at work, school or home. Significantly higher numbers come from the Centers for Disease Control, which in 2019 reported that some 16% of pregnant women . Given the opposition of medical and public health professionals to the criminalization of substance use during pregnancy, an understanding of both the range of criminal charges pregnant substance users may face and the role, if any, that medical expertise has played in the adjudication of these cases would inform understanding of the problem and of medical professional advocacy efforts. Opioids can be prescription or illicit. They help us to know which pages are the most and least popular and see how visitors move around the site. Criminalization has taken many forms including, but not limited to, the passage of fetal assault laws, policies that punish or penalize pregnant people for substance use during pregnancy, and the practice of judicial intervention or legal attempts at coercion for refusal of care during pregnancy. A total of 24 published judicial opinions met the inclusion criteria (Table 1). In males, marijuana is thought to decrease sperm quality and testosterone levels. "Georgia Supreme Court Orders C-Section Mother Nature Reverses on Appeal." . Illegal Drug Use and Pregnancy. 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. The first case was adjudicated in 1977 and the last case in 2015. 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. Tennessee To Decide If It Will Keep Criminalizing Pregnant Women For 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. Taking drugs in pregnancy | Ready Steady Baby! We do not capture any email address. All of these cases were appellate decisions except for one published trial court decision,24 which we discuss separately, given that trial court decisions are not typically published and do not resolve matters of law. Prescribed medicines. Criminalizing Pregnancy: Policing Pregnant Women Who Use Drugs in the If you are pregnant or trying to get pregnant and cannot stop drinking, get help. She had become dependent on opioids, but when she learned she was pregnant, she immediately tried to enroll in a medication assisted treatment (MAT) program. MSACD has currently established relationships with at least one community in every region across the state. Second, they claim that drug use during pregnancy is a reliable indicator of parental unfitness. M. thought she was doing the right thing. Long-term effects of alcohol include: The baby being born with fetal alcohol syndrome (FAS) having symptoms, such as: Physical and facial abnormalities Learning disabilities, such as not being able to concentrate. Opioid abuse, dependence, and addiction in pregnancy, Medication assisted treatment in US drug courts: results from a nationwide survey of availability, barriers and attitudes, Maternal-fetal rights and substance abuse: gestation without representation, Pregnant women and the use of corrections restraints and substance use commitment, New Jersey Division of Child Protection & Permanency v. by Leticia Miranda, Vince Dixon and Cecilia Reyes In three states Minnesota, South Dakota and Wisconsin women who use drugs during pregnancy can be involuntarily committed to a treatment program. There are several limitations to this study. App. The report also found that Kentuckys child protection agency was not making enough efforts to prevent removal or re-entry to foster care. Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women.
