Learn more about e-cigarettes and pregnancy. 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. In totality, medical expertise seemed to play relatively little role in determining the outcome of most judicial decisions. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. More about medicines in pregnancy. Smoking during pregnancy increases the risk of health problems for developing babies, including preterm birth, low birth weight, and birth defects of the mouth and lip. They have 1 child together that was born prematurely due to her drug use. 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. The number of pregnant women with opioid use disorder at labor and delivery more than quadrupled from 1999 to 2014, according to a recent CDC analysis. Twelve opinions noted that other jurisdictions ruled similarly when faced with such cases. State Responses to Substance Abuse Among Pregnant Women, Concerns Mount over Punitive Approaches to Substance Abuse Among Pregnant Women. While medication assisted treatment (MAT) is covered under Arizonas newly expanded Medicaid programs, Arizonans still struggle withaccessto MAT treatment. Many of the early cases were related to maternal cocaine use, whereas more recent cases tended to involve maternal methamphetamine use. 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. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. Eighteen states have laws that say drug use during pregnancy is child abuse. Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. 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. Using illegal drugs during pregnancy is dangerous for an unborn baby and the mother. Dr. Appelbaum is Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law, Department of Psychiatry, Columbia University, and Director, Division of Law, Ethics, and Psychiatry, Columbia College of Physicians and Surgeons, and NY State Psychiatric Institute, New York, NY. Between 1992 and 1995, the number of states that prosecuted drug-addicted pregnant women increased nearly threefold. At least in theory, legislatures could amend criminal laws to make clear that they intend them to apply to prenatal conduct that affects fetuses. 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. Further, some states, under the rubric of protecting the fetus, authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant people who use drugs; these policies sometimes also apply to alcohol use or other behaviors. However, fentanyl has also been manufactured illicitly, and its distribution is on the rise. 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. 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. Exact terminology for relevant crimes varies across states and broad inclusion criteria were used for initial case review. Marijuana remains illegal at the federal level, even as some states have legalized it for recreational and medicinal use. Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. Copyright 2023 by The American Academy of Psychiatry and the Law. 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. 38]. App. Nicotine is a health danger for pregnant women and developing babies and can damage a developing babys brain and lungs. Facts are largely determined at the trial level. 1. Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. 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). For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. 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. More about smoking in pregnancy and drinking alcohol in pregnancy. Criminalization of substance use during pregnancy because of harm to the fetus or child is fiercely debated. 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. CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. Support ProPublica's award-winning investigative journalism. 96 A 2017 opinion posted by . We did not examine judicial decisions regarding women who have faced civil child abuse proceedings related to prenatal substance use. 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. These cases typically involve significant civil matters, such as termination of parental rights or civil commitment to inpatient treatment facilities.55,56 There are instances where women have faced civil complaints for behavior that is consistent with current standards of care for medical treatment of addictions. 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. Drug addiction is a serious problem, especially when the drug addict is pregnant. The Guttmacher Institute is registered as a 501(c)(3) nonprofit organization under the tax identification number 13-2890727. In the three judicial opinions that upheld convictions, the court determined that the legislature intended to include fetuses in the definition of child for the purposes of the relevant statute. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. An example of this reasoning was articulated by the majority in State v. Welch: The South Carolina Supreme Court in McKnight v. State17 referenced its earlier decision in Whitner v. South State16 when it opined that, in several cases this Court has specifically held that the Legislature's use of the term child includes a viable fetus. The court also pointed out that, after the Whitner decision, the legislature did not modify the statute to exclude viable fetuses from its definition of child. Illegal Drugs Marijuana (Cannabis) More research needs to be done on how marijuana use during pregnancy could impact the health and development of infants, given changing policies about access to marijuana, significant increases in the number of pregnant women seeking substance use disorder treatment for marijuana use, and confounding effects of polysubstance use. Dr. Angelotta is Instructor of Psychiatry and Behavioral Sciences, Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL. A newborn infant's death nearly 15 years ago is still causing a fierce legislative battle in Arizona and other states around the country. 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. Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. 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. His girlfriend is also a meth addict. This is all exacerbated by a series of measures Arizona has undertaken to constrict its social safety net, leaving families struggling with inadequate access to cash, food, housing, child care, and transportation. Not coincidentally, in the aftermath of the 2008 financial crisis, as Arizonas social safety net shrank, its foster care numbers soared. If you or someone you know has a drug problem, seek help. M. thought she was doing the right thing. She was charged with chemical endangerment of a child. This is all done under the cloak of what is in the best interest of the childbut that is ironic, because they are hurting my son.. The treating pediatrician opined that the cause of death was respiratory arrest secondary to prematurity, whereas the medical examiner said that the cause of death was acute methamphetamine intoxication.18 Two of the opinions16,30 that directly referenced published medical literature referred to data that supported the conclusion that cocaine use during pregnancy creates a substantial and well-established risk to the unborn child and that this effect is within the scope of public knowledge. Stopping your medication suddenly could be harmful for you and your baby. Local, state, and federal government websites often end in .gov. In that way, this legislations attempt to punish mothers and fathers acts as a civil death penalty for families, for which children will pay the ultimate price.. Her infant tested positive for cocaine shortly after birth. The overwhelming majority of parents prosecuted by the child welfare system are poor, and parents ofcolorare overrepresented. Cocaine lingers in a fetus much longer than an adult and often 5-7 days after birth. In other words, the key concern in the judicial decisions to date has turned on the courts' interpretation of legislative intent. This evolution over time may reflect contemporaneous moral panic linked to the potential deleterious effects of particular substances on fetal outcomes.1. 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. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . Six ruled that the contested application of the statute to conduct during pregnancy violated due process, which requires that criminal offenses be defined in plain language so that an ordinary person has fair notice about the actions proscribed. 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. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. 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. Collaborations have included media messages on maternal substance abuse during pregnancy and supplying resources addressing the use of any substance. Heavy use of marijuana - that is, marijuana with high amounts of THC - has been linked to decreased fertility in both men and women. You will be subject to the destination website's privacy policy when you follow the link. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. 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. 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. 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. DRH presents state and national estimates of marijuana use among pregnant women. 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. 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. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. In Tennessee, this law carries a maximum penalty of 15 years in prison. 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. Support a worker-led Appeal. Neonatal abstinence syndrome (NAS) is itself a treatable and transient condition, anda growing body of literatureconfirms that one of the most effective treatments for NAS is keeping the newborn and mother together in a soothing environment while encouraging skin-to-skin contact and breastfeeding. 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. 31]. Exposing how the U.S. criminal legal system fails to keep people safe and perpetuates harm. We examined only published cases, almost all of which were appellate level decisions. We also identified judicial references to expert or fact witness medical testimony and to medical literature or medical or public health-related amicus briefs. Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. The effects of illegal drugs, such as cocaine, can be devastating on a fetus. Most states do not have a law that requires hospitals to test infants and new moms for controlled substances. 2006), State v. Martinez, 137 P.3d 1195, 1198 (N.M. Ct. App. Yet despite the country's best efforts to fight it, the problem is getting worse, and is exacerbated by the COVID-19 pandemic. All types of alcohol are equally harmful, including all wines and beer. 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. [Ref. 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. Opioids are a class of drugs used to manage pain, but also have serious risks, such as addiction. Dehumanizing Discourse, Anti-drug Law, and Policy in America: A "Crack Mother's" Nightmare . 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. Wisconsin provides priority access to pregnant people in both general and private programs. The infant was born prematurely. 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. Good reproductive health policy starts with credible research. Thank you for taking the time to confirm your preferences. Using illegal drugs while pregnant can cause many complications to the baby including brain damage, premature birth, low birth weight and even fetal death. 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. 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. Visitour state legislation trackerfor policy activity on all sexual and reproductive health topics. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. A representative example is State v. Wade, where the court stated, The plain language of the child endangerment statute does not proscribe conduct harmful to fetuses.40 The courts typically made explicit that any ambiguity in the statutes must be construed liberally in favor of the criminal defendant. Tobacco and alcohol are the most commonly abused substances, followed by marijuana and cocaine. Prenatal drug exposure may also contribute to long-term behavioral effects and developmental deficits. You should also speak to your GP, midwife or a drug support service if you're regularly taking prescribed medicines. by Leticia Miranda, Vince Dixon and Cecilia Reyes Fentanylis a prescription opioid that can be used to treat severe pain. [I]t would be an anomaly, indeed, if the law were such that a pregnant woman who, by ingesting drugs, recklessly caused the death of a viable fetus would suffer no criminal liability for manslaughter but, if the child was born alive and did not die, could be imprisoned for five years for reckless endangerment [Ref. We developed categories of relevant variables to code a priori. 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. Cocaine (including crack cocaine) and methamphetamine (speed, or ice) are powerful stimulants that effect the central nervous system. Maternal deaths in the United States are increasing. She had given birth approximately one year earlier to a child who had also tested positive for cocaine. Federal Drug Laws. Prescription opioids may be prescribed by doctors to manage moderate to severe pain. 1994), Reinesto v. Superior Court, 894 P.2d 733 (Ariz. Ct. App. LEXIS 970 (Tenn. Crim. Both stand to undermine the medical treatment of pregnant women with substance use disorders and potentially increase harm to mothers and children. The laws can vary widely from state to state in terms of reporting requirements and consequences of reporting. Laws on drug testing of infants and new mothers vary, but the stakes are always high. 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. 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. 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. Section 2 of the Georgia Security and Immigration Compliance Act of 2006 (Act 457) requires public employers, their contractors and subcontractors to verify the work eligibility of all newly hired employees through an electronic federal work authorization program. Georgia regulates the possession of both illegal and prescription drugs. Contact your healthcare provider, local Alcoholics Anonymous, or local alcohol treatment center. Fifteen states have laws requiring health care workers to report to authorities if they suspect a woman is abusing drugs during pregnancy. Such inhumane responses to drug use can only exist because they are almost exclusively reserved for poor people and people of color. Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice System Should Step Out and the Affordable Care Act Should Step Up. Getty Creative. All information these cookies collect is aggregated and therefore anonymous. The other opinion33 that directly referenced medical literature did so to demonstrate the range of behaviors that are not legally proscribed (e.g., smoking, failing to obtain prenatal care) that are associated with poor neonatal outcomes. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. For example, pregnant women should drink less than 1 liter (about 3 cans) of diet soda per day. Opioid use disorder among pregnant women is a significant public health concern in the United States. Thus, it is not clear whether racial or economic bias is a factor in these cases. Illegal drugs in pregnancy. 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 report also found that Kentuckys child protection agency was not making enough efforts to prevent removal or re-entry to foster care. Keywords: laws, policies, substance use, care, treatment, infants, neglect Created Date: 8/17/2022 9:48:14 PM For example, a woman in New Jersey faced civil child abuse and neglect proceedings for complying with her doctor's recommendation to stay on methadone treatment while pregnant,57 the gold standard treatment for opioid dependency during pregnancy.53 The proceedings against her were ultimately thrown out by an appellate court. To date, the United States Supreme Court has declined to hear cases that raise questions about the constitutionality of such laws. Narcotics Anonymous World Service Office in Los Angeles PO Box 9999 Van Nuys, California 91409 Telephone: (818) 773-9999 Fax: (818) 700-0700 Web site: www.na.org Substance Abuse and Mental Health Services Administration LEXIS 496 (Tenn. Crim. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. The Supreme Courts in Alabama and South Carolina have upheld convictions ruling that an individuals substance use in pregnancy constitutes criminal child abuse.