(3) 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. 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. We developed categories of relevant variables to code a priori. Substance use in pregnancy is an important issue in antenatal care. Marijuana remains illegal at the federal level, even as some states have legalized it for recreational and medicinal use. Despite a lack of criminal statutes specifically targeting substance use by pregnant women in other states, women have been charged and, infrequently, convicted of a range of criminal offenses for illicit substance use while pregnant, including child abuse, assault, manslaughter, and murder.15 In two states, South Carolina and Alabama, these convictions have been upheld by the state supreme court.16,,18 The effect of these rulings is to permit women to be convicted for substance use during pregnancy under existing laws that are not specific to pregnancy. The search yielded 77 published cases, of which, on closer review, 16 were found to be relevant. 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. Convictions were upheld only in Alabama and South Carolina, involving a total of four women. However, pregnant women with a disease called phenylketonuria shouldn't eat or drink aspartame. 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. 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. 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. 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. Apr 20, 2022, M. Forrest Behne, Craig Waleed, Meghan Peterson, and Lauren Brinkley-Rubinstein To learn about CDC activities to prevent fetal alcohol spectrum disorders, visit About Us from the National Center on Birth Defects and Developmental Disabilities. A neonatologist who was an expert witness for the defense testified that the cocaine derivatives present in the children's urine were from exchange between the womb and placenta during pregnancy and that only a tiny amount of cocaine derivative could have passed through the umbilical cord during the 30- to 60-second period after the child was born and before the umbilical cord was cut. Most states do not have a law that requires hospitals to test infants and new moms for controlled substances. App. 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. Cases of Women Charged With Child Abuse-Related 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 also were unable to determine the race or economic status of the defendants and do not know if poor or minority women are overrepresented among the defendants. Those unable to pay may perform community service instead. Illegal drugs in pregnancy. In three states Minnesota, South Dakota and Wisconsin women who use drugs during pregnancy can be involuntarily committed to a treatment program. In males, marijuana is thought to decrease sperm quality and testosterone levels. An official website of the State of Georgia. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. 2015), The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida, Substance use during pregnancy and postnatal outcomes, Punishing pregnant drug users: enhancing the flight from care, Women's perspectives on screening for alcohol and drug use in prenatal care, Drug use and limited prenatal care: an examination of responsible barriers, Universal screening for alcohol and drug use and racial disparities in child protective services reporting, The American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women and American Society of Addiction Medicine, Committee Opinion No 524. Nicotine is a health danger for pregnant women and developing babies and can damage a developing babys brain and lungs. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice System Should Step Out and the Affordable Care Act Should Step Up. Getty Creative. Kansas and Nebraska have no reporting or testing requirements, the survey says. Enter multiple addresses on separate lines or separate them with commas. 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. Opioids are a class of drugs used to manage pain, but also have serious risks, such as addiction. 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. Criminal or civil penalties discourage women from seeking prenatal care they need for fear of having their drug use discovered, critics say. Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. In many places, women lose their children or end up in behind bars, sometimes even if the drug was prescribed. Studieshave found that babies exposed to cocaine in utero are not at greater risk of maltreatment as young children than similarly situated babies. 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. If youre using marijuana and are pregnant or are planning to become pregnant, talk to your healthcare provider. It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. CDC also works to better understand the association between marijuana use while pregnant with birth outcomes and postpartum experiences, such as depression and breastfeeding. 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. Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. The laws can vary widely from state to state in terms of reporting requirements and consequences of reporting. As is true across the nation, rural areas have limited, if any, access to MAT. They have 1 child together that was born prematurely due to her drug use. 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. We do not know the role that medical expertise and testimony played in influencing the judicial outcome at the trial court level. An example of this reasoning was articulated by the majority in State v. Welch: Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. MSACD is committed to raising the awareness of thedevastating effects of alcohol and other substances whenused during pregnancy. Otherwise, the law on drug testing newborns varies from state to state. Her infant tested positive for cocaine shortly after birth. She had given birth approximately one year earlier to a child who had also tested positive for cocaine. Three courts stated that permitting prosecutions under the contested statute was counterproductive to state policy goals and public health. 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. Heavy use of marijuana - that is, marijuana with high amounts of THC - has been linked to decreased fertility in both men and women. 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. Indeed, Kentucky has one of the highest rates of child removal in the country. Cocaine use during pregnancy poses severe issues for affected babies both short and long-term. Medical and public health experts who are desirous of seeing a greater focus on treatment of substance-abusing pregnant women must stay particularly alert to legislative efforts to expand the legal definition of a child to include fetuses or to define prenatal substance use explicitly as a form of child abuse. 1. Establishes requirements for health care providers to encourage and facilitate drug counseling. 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. "Georgia Supreme Court Orders C-Section Mother Nature Reverses on Appeal." . 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 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. To receive email updates about this page, enter your email address: We take your privacy seriously. " Among pregnant women aged 15 to 44, 5.4 percent were current illicit drug users based on data averaged across 2012 and 2013. 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. Contact your healthcare provider, local Alcoholics Anonymous, or local alcohol treatment center. [Ref. The Guttmacher Institute is registered as a 501(c)(3) nonprofit organization under the tax identification number 13-2890727. 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. by Leticia Miranda, Vince Dixon and Cecilia Reyes Heroin is an illicit opioid. 2006), State v. Martinez, 137 P.3d 1195, 1198 (N.M. Ct. App. Consistent with guidance from the American College of Obstetricians and Gynecologists, CDC advises against using marijuana during pregnancy. In Kilmon v. State, the court said, 1977), State v. Gethers, 585 So.2d 1140, 1143 (Fla. Dist. The first case was adjudicated in 1977 and the last case in 2015. 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. Since 1973, authorities in at least 45 states have tried to prosecute women for exposing unborn children to drugs. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. 1994), Reinesto v. Superior Court, 894 P.2d 733 (Ariz. Ct. App. Civil child abuse proceedings are explicitly permitted in 18 states.9 These may lead to termination of parental rights, but not to prison sentences. At least two states, Arizona and Kentucky, have just made it easier to terminate the rights of mothers who use controlled substances while pregnant. 2005), Kilmon v. State, 905 A.2d 306, 314 (Md. For example, Amanda Kimbrough's child was born prematurely and died shortly after birth, having tested positive for methamphetamine. 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. Later in the pregnancy, these illicit drugs may cause. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. 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 use of illicit substances such as cocaine and heroin during pregnancy is common. Experts recognize that pregnancy and childbirth present an especially opportune moment to connect a woman with services, including substance use disorder treatmentyet threats of punishment onlyisolatepregnant women. The overwhelming majority of parents prosecuted by the child welfare system are poor, and parents ofcolorare overrepresented. Prosecutors have attempted to rely on a host of criminal laws already on the books to attack prenatal substance use. 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. 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 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 . She told her treating physician about her opioid use during pregnancy, not realizing this could precipitate call to Child Protective Services (CPS). This means that first-time offenders will be issued an infraction (like a speeding ticket) instead of jail, with a maximum fine of $150. 2023 Guttmacher Institute. There are several limitations to this study. A mother taking illegal drugs during pregnancy increases her risk for anemia, blood and heart infections, skin infections, hepatitis, and other infectious diseases. This isaccomplished through a statewide OBHP contract withEmory University. That said, there are a few things you should know about "drugs-while-pregnant" law across the U.S.: Most states have tried, at one point or another, to prosecute women for drug use during pregnancy. We do not capture any email address. Drug addiction is a serious problem, especially when the drug addict is pregnant. 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. 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). 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. Reproductive rights are under attack. Terminating a mothers rights to her newborn is an especially brutal drug war tactic that research and experience show will inflict far more harm than good on the children and families it allegedly aims to protect. The use of prescription drugs during pregnancy, excluding supplements, in Ethiopia was high. 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). Visitour state legislation trackerfor policy activity on all sexual and reproductive health topics. MSACD has currently established relationships with at least one community in every region across the state. 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). 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. 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. 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. 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. 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). LEXIS 496 (Tenn. Crim. International Perspectives on Sexual and Reproductive Health (19752020), Perspectives on Sexual and Reproductive Health (19692020). It's best not to stop abruptly without first seeking medical advice as there may be . Additionally, in three states, Minnesota, South Dakota, and Wisconsin, women who use drugs during pregnancy can be involuntarily committed to a treatment program. Meanwhile, private insurance companies have found ways to circumvent Obamacare requirements on MAT coverage. She struggled every day with the unimaginable pain and grief of separation from her newborn. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. Both stand to undermine the medical treatment of pregnant women with substance use disorders and potentially increase harm to mothers and children. However, fentanyl has also been manufactured illicitly, and its distribution is on the rise. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Many substance use treatment services dont accept pregnant women, or are otherwiseinaccessibleto them, despitefederalandstateregulations that require prioritizing them for treatment. 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. Contributions are tax deductible to the fullest extent allowable. Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. 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. Among pregnant women aged 15 to 44, the average . 2007), State v. Hudson, 2007 Tenn. Crim. Quitting early or before pregnancy is best, but its never too late to quit smoking. Prevalence of Current Substance Use Among Pregnant People in the US. 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. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. In the subsequent months, M. saw her son once a week at best. While medication assisted treatment (MAT) is covered under Arizonas newly expanded Medicaid programs, Arizonans still struggle withaccessto MAT treatment. 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. In the 22 judicial opinions wherein charges were dismissed or convictions overturned, all held that the legislature did not intend to include fetuses in the definition of a child or victim in the relevant statute. Opioids can be prescription or illicit. Similarly, in Ankrom v. State, the state supreme court found that the plain meaning of the word child is broad enough to encompass all childrenborn and unborn.18 When fetuses are included in the definition of child, the child abuse statutes are then found to be applicable to the alleged prenatal conduct.