Maternal deaths in the United States are increasing. Pregnancy. Priority applies to pregnant people referred for treatment. 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. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. Between 2002-2003 and 2016-2017, past-month cannabis use increased from 3.4% to 7.0% among pregnant women overall and from 5.7% to 12.1% during the first trimester. 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. An official website of the State of Georgia. Learn about the Division of Reproductive Healths efforts to address opioid use disorder to improve maternal and infant health. 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. For example, pregnant women should drink less than 1 liter (about 3 cans) of diet soda per day. Eighteen states have laws that say drug use during pregnancy is child abuse. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. Ct. App. 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. Kansas and Nebraska have no reporting or testing requirements, the survey says. 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. Despite several phone calls to treatment providers in her county and surrounding counties, M. could not find a provider who was willing to accept her. Collaborations have included media messages on maternal substance abuse during pregnancy and supplying resources addressing the use of any substance. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. 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. App. Despite progress in the criminal legal system, the drug war remains almost unchallenged in the child protection system, and it is wreaking havoc on families. 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. An obvious example is the recent Tennessee law that explicitly made illicit drug use during pregnancy a form of criminal assault. Illegal drugs in pregnancy. 2007), State v. Hudson, 2007 Tenn. Crim. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice System Should Step Out and the Affordable Care Act Should Step Up. 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). Research projects funded by both state and federal agencies continue to examine effects of prenatal exposure on development, evaluate intervention programs, and describe the clinic population using comprehensive databases. 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 Kilmon v. State, the court said, The balance in the courts in favor of treating substance use during pregnancy as a medical problem depends on the definition of a child for the purposes of criminal statutes. The Center houses the Emory Neurodevelopmental Exposures Clinic (ENEC), a multidisciplinary clinic dedicated to providing evaluation and intervention services to individuals exposed to substances in pregnancy. 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. Facts are largely determined at the trial level. 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. Drug Use by State: Problem Areas. The implication for medical experts is that advocacy efforts may be most useful when focused on state legislatures that are contemplating policies to reduce harms associated with prenatal substance abuse. The Guttmacher Institute is registered as a 501(c)(3) nonprofit organization under the tax identification number 13-2890727. 2005), Kilmon v. State, 905 A.2d 306, 314 (Md. 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. Opioid use disorder among pregnant women is a significant public health concern in the United States. Termination of parental rights is a mechanism by which families are turned into strangers, all contact and personal identity is erased, and families are destroyed forever. Applying CDCs Guideline for Prescribing Opioids: Substance Abuse and Mental Health Services Administration: American College of Obstetricians and Gynecologists (ACOG) Committee Opinion: The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Finally, a number of states have placed a priority on making drug treatment more readily available to pregnant individuals, which is bolstered by federal funds that require prioritized access to treatment programs for anyone who is pregnant. Exact terminology for relevant crimes varies across states and broad inclusion criteria were used for initial case review. Laws on drug testing of infants and new mothers vary, but the stakes are always high. How some hospitals are drug testing new mothers without consent, How Alabamas meth lab law is unfairly punishing pregnant women, Mothers: tell us about drug testing at your hospital. More and more states are adopting drug testing for newborns because of the recent increase in opioid use . The court also referred to rulings by appellate courts in other jurisdictions that had held similarly in comparable cases. 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. 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. She was charged with chemical endangerment of a child. CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. 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. Among pregnant women aged 15 to 44, the average . 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. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Only two courts found for the defendant, in part on the grounds that there was no medical evidence to support the charge. Hence, health care providers should select relatively safe drugs. 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. Stakeholders should ensure safe prescribing practice for pregnant women through developin Published on September, 30, 2015. 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. As part of CDCs efforts to prevent overdoses and substance use-related harms, CDC is taking specific actions to prevent opioid use disorder among pregnant women and women who could become pregnant and to make sure women with opioid use disorder get proper treatment. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. The Guttmacher Institute, which researches reproductive health issues, says 18 states consider abusing substances during pregnancy to be child abuse under civil child welfare laws, and Tennessee . It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. In other instances, where medical expertise was referenced, it did not necessarily support the defendants' position. Prescription opioids may be prescribed by doctors to manage moderate to severe pain. 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. Maternal Substance Abuse and Child Development Project | Georgia Department of Behavioral Health and Developmental Disabilities For access to services and immediate crisis help, call the Georgia Crisis & Access Line (GCAL) at 1-800-715-4225, available 24/7. App. Such policies are rooted in stigma and gross indifference to what the best available science tells us about how to compassionately and effectively serve pregnant women struggling with drug use disorders and their families. Later in the pregnancy, these illicit drugs may cause. 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. Contributions are tax deductible to the fullest extent allowable. Babies exposed to cocaine in the womb have a 25 percent increased chance of being born premature. 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. (3) Support a worker-led Appeal. If you or someone you know has a drug problem, seek help. Georgia regulates the possession of both illegal and prescription drugs. Federal Drug Laws. 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. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. The child was placed with CPS and now is in the custody of the great grandmother. These cookies may also be used for advertising purposes by these third parties. 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. Prescribed medicines. His girlfriend is also a meth addict. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. Heavy use of marijuana - that is, marijuana with high amounts of THC - has been linked to decreased fertility in both men and women. Illegal Drug Use and Pregnancy. In Tennessee, this law carries a maximum penalty of 15 years in prison. The substances being abused during pregnancy can include alcohol, cocaine, heroin, and opioid addiction. There are several limitations to this study. Moreover, there is a great deal of overlap between drug use during pregnancy policies and alcohol/pregnancy policies. MSACD is committed to raising the awareness of thedevastating effects of alcohol and other substances whenused during pregnancy. A total of 24 published judicial opinions met the inclusion criteria (Table 1). 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. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. Drug use is an uncommon cause of birth defects, yet approximately 200,000 children (3-5% of live births) are born with birth defects each year. An official website of the State of Georgia. Katie Jane Fernelius 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. State laws now vary considerably in their approach to the problem, reflecting a deep division in public opinion. Wisconsin provides priority access to pregnant people in both general and private programs. M. thought she was doing the right thing. It's best not to stop abruptly without first seeking medical advice as there may be . 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. Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. 19 states have 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. Critics argue law will deter women from seeking treatment. Drug addiction is a serious problem, especially when the drug addict is pregnant. Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. Proceedings resulted in dismissal of the charges or convictions overturned for 86.2 percent of the women. In Johnson v. State, the defendant was charged and convicted of two counts of delivery of a controlled substance to a minor via the umbilical cord after she reported to the treating obstetrician that she had smoked marijuana and crack cocaine the day she went into labor. This means that first-time offenders will be issued an infraction (like a speeding ticket) instead of jail, with a maximum fine of $150.