Some research shows that marijuana use during pregnancy is linked to health concerns, including high use of other substances that may impact pregnancy and infant health such as tobacco, and developmental problems in adolescents. First, they say the developing fetus and newborn will be harmed by prenatal exposure to illicit substances. 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. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. For example, pregnant women should drink less than 1 liter (about 3 cans) of diet soda per day. International Perspectives on Sexual and Reproductive Health (19752020), Perspectives on Sexual and Reproductive Health (19692020). There is also no safe time during pregnancy to drink. The Center for MSACD also provides training, workshops, and other informational services concerning prenatal exposure to alcohol, nicotine, illicit drugs, and prescription drugs. Second, they claim that drug use during pregnancy is a reliable indicator of parental unfitness. Between 1992 and 1995, the number of states that prosecuted drug-addicted pregnant women increased nearly threefold. 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. 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. 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. Neonatal abstinence syndrome . This claim disregards the fact that drug addiction is ahealth issuewith biological, behavioral, and genetic dimensions, and similar to other health conditions, itdoes not respond wellto artificially imposed treatment timelines or mandated treatment. Among pregnant women aged 15 to 44, the average . Eighteen states have laws that say drug use during pregnancy is child abuse. 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. In three of the cases in which medical expert testimony was referenced, the expert testimony was contradictory. Millions ofparentswho use drugs or have substance use disorders parent their children well. 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. -- A Tennessee woman is the first to be charged under a new state law that specifically makes it a crime to take drugs while pregnant . 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. As of 2018, 38 states had . They have 1 child together that was born prematurely due to her drug use. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . Prescription opioids may be prescribed by doctors to manage moderate to severe pain. 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. Daily/near daily cannabis use in the past month increased from 0.9% to 3.4% among pregnant women overall, and from 1.8% to 5.3% during the first trimester; from 0.6% to 2.5% during . The court held that the legislature did not intend for the relevant statute to apply to conduct during pregnancy that affected fetuses. This isaccomplished through a statewide OBHP contract withEmory University. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. Drug Use by State: Problem Areas. 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. 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. The effects of illegal drugs, such as cocaine, can be devastating on a fetus. The court also referred to rulings by appellate courts in other jurisdictions that had held similarly in comparable cases. An official website of the State of Georgia. App. 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. At the present time, the Center for MSACD fulfills several roles in Georgia by sponsoring clinical, prevention, and research programs. In the subsequent months, M. saw her son once a week at best. However, in 2015, law enforcement cracked down on drug use during pregnancy. Consistent with guidance from the American College of Obstetricians and Gynecologists, CDC advises against using marijuana during pregnancy. 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). Ct. App. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice System Should Step Out and the Affordable Care Act Should Step Up. Not coincidentally, in the aftermath of the 2008 financial crisis, as Arizonas social safety net shrank, its foster care numbers soared. 1. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome (SIDS). The research that does claim to link substance use to maltreatment of children is not authoritative. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. Learn more about e-cigarettes and pregnancy, pregnant women or women planning to have a baby, National Center for Chronic Disease Prevention and Health Promotion, How to Manage Your Chronic Disease During a Disaster, Disaster Safety for Expecting and New Parents, Tools and Resources for Public Health Professionals, Safety Messages For Pregnant, Postpartum, and Breastfeeding People During Disasters, Maternal and Child Health Epidemiology Program, Pregnancy Risk Assessment Monitoring System, Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 20172019, Pregnancy-Related Deaths Among American Indian or Alaska Native Persons: Data from Maternal Mortality Review Committees in 36 US States, 20172019, Maternal Mortality Review Information Application, State Strategies for Preventing Pregnancy-Related Deaths, Infographic: Racial/Ethnic Disparities in Pregnancy-Related Deaths United States, 20072016, Addressing Opioid Use Disorder to Improve Maternal and Infant Health, Working with States, Federal Partners, and National Organizations, Infographic: The US Opioid Crisis & Maternal and Infant Health, National Network of Perinatal Quality Collaboratives, Perinatal Quality Collaboratives: Working Together to Improve Maternal Outcomes, CDC Contraceptive Guidance for Health Care Providers, eBook: Selected Recommendations for Contraceptive Use, Providing Quality Family Planning Services, Data and Statistics: Need for Contraceptive Services Among Women of Reproductive Age, Common Reproductive Health Concerns for Women, Monitoring and Evaluating Maternal and Child Health Programs, Infographic of Saving Mothers, Giving Life Approach, Infographic: Saving Mothers, Giving Life in Uganda, Infographic: Saving Mothers, Giving Life Path to Safe Motherhood, Monitoring and Evaluation to Document SMGLs Progress, Maternal and Reproductive Health in Tanzania Project, Improving Access to Quality Maternity Care to Reduce Maternal and Newborn Deaths, Monitoring and Evaluating to Document the Health Improvements, Strengthening Maternal and Newborn Health Surveillance Systems, U.S. Department of Health & Human Services. 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. 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. 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. Future professional advocacy efforts may be most beneficial when directed at state legislatures that are dealing with proposed statutes that address these questions. Fetal Assault Laws. This evolution over time may reflect contemporaneous moral panic linked to the potential deleterious effects of particular substances on fetal outcomes.1. 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. More mothers may soon know M.s pain. 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. Support a worker-led Appeal. 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. It's best not to stop abruptly without first seeking medical advice as there may be . In 2014, Tennessee became the first (and only) state to pass a law that criminalized drug use during pregnancy, after a district court judge added an additional six years to the prison sentence of a woman who had been involved in a methamphetamine manufacturing operation while pregnant. For each case, we recorded the charges, the substance abused, neonatal outcome, legal resolution of the case, and judicial reasoning. You can also go to SAMHSAs Behavioral Health Treatment Services Locator. The National Survey on Drug Use and Health (NSDUH), conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides nationally representative data on the use of tobacco, alcohol, and illicit drugs; substance use disorders; receipt of substance use treatment; mental health issues; and the use of mental health Opioids can be prescription or illicit. Stopping your medication suddenly could be harmful for you and your baby. 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. 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. 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. 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. Proceedings resulted in dismissal of the charges or convictions overturned for 86.2 percent of the women. CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. Thus, it is not clear whether racial or economic bias is a factor in these cases. 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. Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. Three courts stated that permitting prosecutions under the contested statute was counterproductive to state policy goals and public health. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. 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. 1. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Subscribe to our newsletters for regular updates, analysis and context straight to your email. Studieshave found that babies exposed to cocaine in utero are not at greater risk of maltreatment as young children than similarly situated babies. The state argued that the drug delivery occurred via the umbilical cord in the period after birth but before the cord was clamped. Criminalization of substance use during pregnancy because of harm to the fetus or child is fiercely debated. Unless otherwise noted, you can republish our stories for free if you follow these rules. Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. 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. Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. 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 progress in the criminal legal system, the drug war remains almost unchallenged in the child protection system, and it is wreaking havoc on families. Reyes was charged with two counts of felony child endangerment for her heroin use Drug use during pregnancy is a severe problem worldwide because it exposes not only the woman but also her developing baby to harmful substances. Exact terminology for relevant crimes varies across states and broad inclusion criteria were used for initial case review. Nicotine is a health danger for pregnant women and developing babies and can damage a developing babys brain and lungs. Cookies used to make website functionality more relevant to you. In males, marijuana is thought to decrease sperm quality and testosterone levels. App. Criminal or civil penalties discourage women from seeking prenatal care they need for fear of having their drug use discovered, critics say. The survey also notes that if prenatal drug use is suspected, Illinois, Michigan, Ohio and Wisconsin require health professionals to report it while Indiana requires pregnant women to be tested; Iowa, Minnesota, North Dakota and South Dakota require both. Using illegal drugs during pregnancy is dangerous for an unborn baby and the mother. Learn more about e-cigarettes and 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. 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. A new study co-authored by a University of Central Florida researcher shows that laws that punish substance use during pregnancy actually do more harm than good. 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. In totality, medical expertise seemed to play relatively little role in determining the outcome of most judicial decisions. State Responses to Substance Abuse Among Pregnant Women, Concerns Mount over Punitive Approaches to Substance Abuse Among Pregnant Women. Quitting smoking is one of the most important ways you can protect your health and the health of your baby. The new requirements become effective on July 1, 2007 A total of 24 published judicial opinions met the inclusion criteria (Table 1). Cases wherein charges resulted in civil proceedings only (e.g., custody proceedings) were not included. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. The use of illicit substances such as cocaine and heroin during pregnancy is common. 31]. 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. 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. 2007), State v. Hudson, 2007 Tenn. Crim. 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? Apr 20, 2022, M. Forrest Behne, Craig Waleed, Meghan Peterson, and Lauren Brinkley-Rubinstein Such laws may discourage people from seeking prenatal care. 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. 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. Ct. App. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. The overwhelming majority of parents prosecuted by the child welfare system are poor, and parents ofcolorare overrepresented. An example of this reasoning was articulated by the majority in State v. Welch: Dr. Angelotta is Instructor of Psychiatry and Behavioral Sciences, Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL. Convictions were upheld only in Alabama and South Carolina, involving a total of four women. Three of the key areas in which they can have an effect are 1) adhering to safe prescribing practices, 2) encouraging healthy behaviors by providing appropriate information and education, and 3) identifying and referring patients already abusing drugs to addiction treatment professionals 13. We did not examine judicial decisions regarding women who have faced civil child abuse proceedings related to prenatal substance use. 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. Although pregnancy is an exciting time, there are stresses and risks that come with pregnancy and the postpartum period. 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. 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.. 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. 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. You can also call 1-800-QUIT-NOW (1-800-784-8669) for free support. Published on September, 30, 2015. 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.

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