10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. 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. New Jersey, however, does not view drug use during pregnancy as constituting child abuse or neglect on its own, unlike other states. "Complex Calculations: How Drug Use during Pregnancy Becomes a Barrier to Prenatal Care." . Cases were decided by state supreme courts (n = 15) and state courts of appeals (n = 14). "Georgia Supreme Court Orders C-Section Mother Nature Reverses on Appeal." . [Ref. Opioids are a class of drugs used to manage pain, but also have serious risks, such as addiction. 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. The city of Savannah decriminalized the possession of marijuana, effective July 1, 2018. In females, there is evidence that marijuana use may disrupt the menstrual cycle. 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. 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. 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. 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 *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. 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. 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. Urine screening remains the most commonly used method despite the limited period during which drugs can be detected. Federal drug laws exist to control the use, manufacturing, possession, and distribution of various drugs that are legal and illegal. A study Wexelblatt led between 2012 and 2013 found 5.4% of all mothers had a positive drug test on admission and 3.2% of the mothers tested positive for opioids. While a robust body of literature supports a causal connection between prenatal exposure to alcohol or tobacco (or lead or poverty for that matter) and negative postnatal health outcomes, thescientific literaturehas not conclusively demonstrated any long-term negative effect of prenatal exposure to opioids. At issue is whether the continued drug use of a newborn's mother is tantamount to "child abuse" that would give child protective services workers and law enforcement officers the ability to remove the child from the mother's care - even if the . As is true across the nation, rural areas have limited, if any, access to MAT. An official website of the State of Georgia. The report also found that Kentuckys child protection agency was not making enough efforts to prevent removal or re-entry to foster care. 1. Hair has been recognized as a possible alternate test specimen, but wider acceptance of hair testing must await . Criminalization of substance use during pregnancy because of harm to the fetus or child is fiercely debated. 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. Moreover, there is a great deal of overlap between drug use during pregnancy policies and alcohol/pregnancy policies. 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. Before sharing sensitive or personal information, make sure youre on an official state website. Quitting early or before pregnancy is best, but its never too late to quit smoking. 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. July 14, 2014 -- Though the first mother has been charged under a new Tennessee law that makes it a crime to use drugs while pregnant, many of the most respected medical groups have opposed . 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. 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. SUBSTANCE USE DURING PREGNANCY CONSIDERED: WHEN DRUG USE DIAGNOSED OR SUSPECTED, STATE REQUIRES: Pregnant People Given Priority Access in General Programs, Pregnant People Protected from Discrimination in Publicly Funded Programs. As of last year, they were still apart, and M. has since lost touch with her lawyer. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . Eighteen states have laws that say drug use during pregnancy is child abuse. There are several limitations to this study. Second, they claim that drug use during pregnancy is a reliable indicator of parental unfitness. A November study published in the Journal of the American Medical Association tracked the rise of laws that criminalized taking drugs while pregnant, as well as classifying drug use during pregnancy as child abuse that could result in loss of custody rights or as grounds for a civil commitment. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. CDC also works to better understand the association between marijuana use while pregnant with birth outcomes and postpartum experiences, such as depression and breastfeeding. 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. The substances related to the charges included cocaine, heroin, methamphetamine, marijuana, and prescription pills. Additional factors were relevant to the stated judicial rationale in at least some of the cases. 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. 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. Learn about the Division of Reproductive Healths efforts to address opioid use disorder to improve maternal and infant health. 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. Quitting tobacco can be hard, but it is possible. Consistent with guidance from the American College of Obstetricians and Gynecologists, CDC advises against using marijuana during pregnancy. Kentuckyslegislation, which also became law last month, permits termination of a mothers parental rights if her newborn exhibits signs of withdrawal, known as neonatal abstinence syndrome, as the result of illicit opioid use, unless the mother is in substantial compliance with both a drug treatment program and a regimen of postnatal care within 90 days of giving birth. " Among pregnant women aged 15 to 44, 5.4 percent were current illicit drug users based on data averaged across 2012 and 2013. 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. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. It found that parents face long wait lists when accessing substance use treatment services and often dont have the means to pay. If a woman is drinking alcohol during pregnancy, it is never too late to stop. In Kilmon v. State, the court said, CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. Nicotine is a health danger for pregnant women and developing babies and can damage a developing babys brain and lungs. In three of the cases in which medical expert testimony was referenced, the expert testimony was contradictory. Here is a survey of state laws. 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. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. Disclosures of financial or other potential conflicts of interest: None. Contact your healthcare provider, local Alcoholics Anonymous, or local alcohol treatment center. In Tennessee, this law carries a maximum penalty of 15 years in prison. 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. 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. 1995), State v. Dunn, 916 P.2d 952 (Wash. Ct. App. 2006), State v. Wade, 232 S.W.3d 663, 665 (Mo. 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. MSACD is committed to raising the awareness of thedevastating effects of alcohol and other substances whenused during pregnancy. Meanwhile, several states have expanded their civil child-welfare requirements to include prenatal substance use, so that prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. The Tips campaign features information about how smoking and secondhand smoking affect specific groups, including pregnant women or women planning to have a baby. 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). While medication assisted treatment (MAT) is covered under Arizonas newly expanded Medicaid programs, Arizonans still struggle withaccessto MAT treatment. Women might use opioids as prescribed, misuse prescription opioids, use illicit opioids such as heroin, or use opioids (opioid agonists and/or antagonists) as treatment for opioid use disorder. App. Heroin is an illicit opioid. Unless otherwise noted, you can republish our stories for free if you follow these rules. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 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. Enter multiple addresses on separate lines or separate them with commas. Collaborations have included media messages on maternal substance abuse during pregnancy and supplying resources addressing the use of any substance. 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. For each case, we recorded the charges, the substance abused, neonatal outcome, legal resolution of the case, and judicial reasoning. Four courts noted that allowing a conviction would result in an absurd punishment scheme. In other instances, where medical expertise was referenced, it did not necessarily support the defendants' position. One published trial court decision was identified.24 In this case, a New York trial court in 1992 dismissed the charge of child endangerment for cocaine ingestion during pregnancy. More and more states are adopting drug testing for newborns because of the recent increase in opioid use . The groups listed below help people with drug abuse. 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. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice System Should Step Out and the Affordable Care Act Should Step Up. 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. 2005), Richards v. State, 2005 Tenn. Crim. Millions ofparentswho use drugs or have substance use disorders parent their children well. Stakeholders should ensure safe prescribing practice for pregnant women through developin 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. State Policies on Substance Use During Pregnancy. Georgia Marijuana Statutes 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. Substance use in pregnancy is an important issue in antenatal care. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby. Support ProPublica's award-winning investigative journalism. This helps clinicians better understand the prevalence of marijuana use as they care for their pregnant patients and provide screening and treatment. For example, pregnant women should drink less than 1 liter (about 3 cans) of diet soda per day. Only two courts found for the defendant, in part on the grounds that there was no medical evidence to support the charge.