You can review and change the way we collect information below. These unintended consequences include keeping women from getting the treatment they need and failing to reduce the number of babies addicted to drugs. 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. 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. Second, they claim that drug use during pregnancy is a reliable indicator of parental unfitness. Local, state, and federal government websites often end in .gov. 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. Establishes requirements for health care providers to encourage and facilitate drug counseling. 1995), State v. Dunn, 916 P.2d 952 (Wash. Ct. App. Consistent with guidance from the American College of Obstetricians and Gynecologists, CDC advises against using marijuana during pregnancy. Video Transcribed: Life imprisonment for using drugs while pregnant.I'm Tulsa criminal defense attorney James Wirth, and we're talking about a new law in Oklahoma.And that became effective in September of 2020, and it essentially provides that mothers to be who use drugs or CDS, while pregnant, can be prosecuted for child neglect, receiving up to life imprisonment. 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. 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. MSACD is committed to raising the awareness of thedevastating effects of alcohol and other substances whenused during pregnancy. Marijuana is the most widely used illegal drug during pregnancy in the U.S., and marijuana use is on the rise among all adult age groups, both sexes, and pregnant women. Healthy pregnancies are essential for the well-being of mothers, infants, families and communities. Women charged with or convicted of crimes against their child or fetus related to substance use during pregnancy have won on appeal much more often than they have lost. 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. 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. The child was placed with CPS and now is in the custody of the great grandmother. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 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. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Marijuana remains illegal at the federal level, even as some states have legalized it for recreational and medicinal use. [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. Cases were decided by state supreme courts (n = 15) and state courts of appeals (n = 14). If you valued this article, please help us produce more journalism like this by making a contribution today. 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. Approximately 700 women in the United States die every year . As is true across the nation, rural areas have limited, if any, access to MAT. Additionally, in three states, Minnesota, South Dakota, and Wisconsin, women who use drugs during pregnancy can be involuntarily committed to a treatment program. Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. 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. by Leticia Miranda, Vince Dixon and Cecilia Reyes 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. We do not know the role that medical expertise and testimony played in influencing the judicial outcome at the trial court level. Priority applies to pregnant people referred for treatment. Meanwhile, private insurance companies have found ways to circumvent Obamacare requirements on MAT coverage. Tennessee is the only state with a statute that specifically makes it a crime to use drugs while pregnant. She told her treating physician about her opioid use during pregnancy, not realizing this could precipitate call to Child Protective Services (CPS). Here is a survey of state laws. 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. No adverse neonatal outcomes were reported in 41 percent of the pregnancies in this study. Support ProPublica's award-winning investigative journalism. Theresearchis also clear that the results of a drug test alone are not an appropriate proxy for determining parental fitness. State Policies on Substance Use During Pregnancy. Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. Ct. App. 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. Through these efforts, the Center for MSACD continues to be a valuable resource to individuals, parents, and professionals in Georgia and the Southeast. First, they say the developing fetus and newborn will be harmed by prenatal exposure to illicit substances. 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. Learn more about e-cigarettes and pregnancy. At least in theory, legislatures could amend criminal laws to make clear that they intend them to apply to prenatal conduct that affects fetuses. 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.. Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. MSACD has currently established relationships with at least one community in every region across the state. There were over 100,000 drug overdose . Since 1973, authorities in at least 45 states have tried to prosecute women for exposing unborn children to drugs. 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. To receive email updates about this page, enter your email address: We take your privacy seriously. Opioid use during pregnancy can affect women and their babies. There may be many more unpublished trial decisions, the dimensions of which we have no way of assessing. All types of alcohol are equally harmful, including all wines and beer. Fentanylis a prescription opioid that can be used to treat severe pain. Illegal Drug Use and Pregnancy. To date, the United States Supreme Court has declined to hear cases that raise questions about the constitutionality of such laws. Contributions are tax deductible to the fullest extent allowable. App. 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. remove barriers to pregnant women with substance use disorders from getting evidence-based treatment that's tailored to their unique needs. 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. How you know. While medication assisted treatment (MAT) is covered under Arizonas newly expanded Medicaid programs, Arizonans still struggle withaccessto MAT treatment. 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. The effects of illegal drugs, such as cocaine, can be devastating on a fetus. DRH presents state and national estimates of marijuana use among pregnant women. Aspartame. Arizona now has one of the highest foster care placement rates in the nation. 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. While the findings varied dependent upon county, across the board, only 18 received any kind of rehab/treatment for drug abuse as . A newborn infant's death nearly 15 years ago is still causing a fierce legislative battle in Arizona and other states around the country. Both stand to undermine the medical treatment of pregnant women with substance use disorders and potentially increase harm to mothers and children. Copyright 2023 by The American Academy of Psychiatry and the Law. Heavy use of marijuana - that is, marijuana with high amounts of THC - has been linked to decreased fertility in both men and women. 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. Mar 02, 2022. It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. The substances being abused during pregnancy can include alcohol, cocaine, heroin, and opioid addiction. As of last year, they were still apart, and M. has since lost touch with her lawyer. From 2009 to 2017, the adjusted prevalence of cannabis use in the year before pregnancy increased from 6.8% to 12.5%, and the adjusted prevalence of cannabis use during pregnancy increased from 1.95% to 3.38 percent. For example, the Maryland state law that permits manslaughter or murder charges if a person kills a viable fetus has an exception that does not permit a woman to be charged with manslaughter for actions that led to the death of her own viable fetus. Despite the opposition of medical and public health professionals, several state legislatures are considering laws that permit child abuse charges for substance use during pregnancy. 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. 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). Otherwise, the law on drug testing newborns varies from state to state. Cocaine (including crack cocaine) and methamphetamine (speed, or ice) are powerful stimulants that effect the central nervous system. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Anonymous screening of consecutive urine samples testing positive for pregnancy from a UK inner-city clinic demonstrated that approximately 16% of the women had taken one or more illicit substances (Sherwood et al, 1999). CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. Such inhumane responses to drug use can only exist because they are almost exclusively reserved for poor people and people of color. Opioid use disorder during pregnancy has been linked with serious negative health outcomes for pregnant women and developing babies, including preterm birth, stillbirth, maternal mortality, and neonatal abstinence syndrome (NAS). Convictions were upheld only in Alabama and South Carolina, involving a total of four women. 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. Using drugs while pregnant and addiction is a grave concern because it puts two lives at risk. Medical and public health authoritieswarn that women who fear losing their babies upon seeking medical care will bedeterredfrom seeking the care they need. 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. Stakeholders should ensure safe prescribing practice for pregnant women through developin Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. Additional factors were relevant to the stated judicial rationale in at least some of the cases. 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. 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. If you are pregnant or trying to get pregnant and cannot stop drinking, get help. Support a worker-led Appeal. 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. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. 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. We did not examine judicial decisions regarding women who have faced civil child abuse proceedings related to prenatal substance use. 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. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. 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. 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. An official website of the State of Georgia. Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. If a woman is drinking alcohol during pregnancy, it is never too late to stop. 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. 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.. Exact terminology for relevant crimes varies across states and broad inclusion criteria were used for initial case review. Katie Jane Fernelius In the family court systems, there is no respect for medicine or science, she wrote. In the subsequent months, M. saw her son once a week at best. 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. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome (SIDS). 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). 2023 Guttmacher Institute. CDC also works to better understand the association between marijuana use while pregnant with birth outcomes and postpartum experiences, such as depression and breastfeeding. Of the 24 judicial opinions, only nine directly referenced medical evidence in the form of medical expert testimony (n = 7), published medical literature (n = 3), or amicus briefs (n = 1). Later in the pregnancy, these illicit drugs may cause. A total of 24 published judicial opinions met the inclusion criteria (Table 1). 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. In males, marijuana is thought to decrease sperm quality and testosterone levels. Millions ofparentswho use drugs or have substance use disorders parent their children well. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. 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. Unless otherwise noted, you can republish our stories for free if you follow these rules. She had given birth approximately one year earlier to a child who had also tested positive for cocaine. 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. Exposing how the U.S. criminal legal system fails to keep people safe and perpetuates harm. Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. The mother was a drug addict. Heroin is an illicit opioid. They have 1 child together that was born prematurely due to her drug use. Prescribed medicines. 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. Before sharing sensitive or personal information, make sure youre on an official state website. The Center for MSACD also provides training, workshops, and other informational services concerning prenatal exposure to alcohol, nicotine, illicit drugs, and prescription drugs. His girlfriend is also a meth addict. For example, onestudyfound that parents who use opiates find babies less cutewhile conceivably notable, this finding does not meet the legal standard for terminating a parents rights. The decisions do not go so far as to say that it would be unlawful for the legislature explicitly to prohibit substance use during pregnancy, although questions about the constitutionality of such an approach have been raised in the legal literature.2,3,20 Rather, most of the decisions simply found that the legislature did not intend for the existing criminal laws to apply to prenatal conduct. We identified 24 judicial opinions published between 1977 and 2015 in cases involving 29 women prosecuted in 19 states.