Approximately 700 women in the United States die every year . Establishes requirements for health care providers to encourage and facilitate drug counseling. 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. If a woman is drinking alcohol during pregnancy, it is never too late to stop. CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. If you regularly use drugs, it's important to tackle this now you're pregnant. Neonatal abstinence syndrome . *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. To date, the United States Supreme Court has declined to hear cases that raise questions about the constitutionality of such laws. All information these cookies collect is aggregated and therefore anonymous. If you or someone close to you needs help for a substance use disorder, talk to your healthcare provider or call SAMHSAs National Helpline at1-800-662-HELP. CDC twenty four seven. This was lower than the rate among women in this age group who were not pregnant (11.4 percent). 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. Ct. App. Tennessee is the only state that has enacted a law that targets substance use by pregnant women on the basis of presumed harm to the fetus or child. 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. The city of Savannah decriminalized the possession of marijuana, effective July 1, 2018. In other words, the key concern in the judicial decisions to date has turned on the courts' interpretation of legislative intent. Prescription opioids may be prescribed by doctors to manage moderate to severe pain. International Perspectives on Sexual and Reproductive Health (19752020), Perspectives on Sexual and Reproductive Health (19692020). More mothers may soon know M.s pain. While medication assisted treatment (MAT) is covered under Arizonas newly expanded Medicaid programs, Arizonans still struggle withaccessto MAT treatment. 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. Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. Although pregnancy is an exciting time, there are stresses and risks that come with pregnancy and the postpartum period. The Supreme Courts in Alabama and South Carolina have upheld convictions ruling that an individuals substance use in pregnancy constitutes criminal child abuse. Illegal Drug Use and 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. 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. Exposing how the U.S. criminal legal system fails to keep people safe and perpetuates harm. MAT is the standard of care for treating people with opioid use disorder especially pregnant women, as quitting opioids too suddenly during pregnancy can result in complications. The substances being abused during pregnancy can include alcohol, cocaine, heroin, and opioid addiction. 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. Briefs from medical or public health organizations were submitted to the court in seven of the cases, all supporting the defendant's position. Since the late 1980s, policymakers have debated the question of how society should deal with the problem of substance use during pregnancy. Eighteen states have laws that say drug use during pregnancy is child abuse. Supporters of these laws blame the mothers for the dissolution of their families, arguing that the mothers need only enroll in a drug treatment program to retain custody of their children. Additional factors were relevant to the stated judicial rationale in at least some of the cases. Cookies used to make website functionality more relevant to you. 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). 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. In three of the cases in which medical expert testimony was referenced, the expert testimony was contradictory. At least two states, Arizona and Kentucky, have just made it easier to terminate the rights of mothers who use controlled substances while pregnant. Drug use is an uncommon cause of birth defects, yet approximately 200,000 children (3-5% of live births) are born with birth defects each year. App.3d 214 (Cal. As of last year, they were still apart, and M. has since lost touch with her lawyer. Stakeholders should ensure safe prescribing practice for pregnant women through developin Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. 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. To receive email updates about this page, enter your email address: We take your privacy seriously. 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. There may be many more unpublished trial decisions, the dimensions of which we have no way of assessing. 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. Marijuana remains illegal at the federal level, even as some states have legalized it for recreational and medicinal use. Not coincidentally, in the aftermath of the 2008 financial crisis, as Arizonas social safety net shrank, its foster care numbers soared. An official website of the State of Georgia. 31]. CDC also works to better understand the association between marijuana use while pregnant with birth outcomes and postpartum experiences, such as depression and breastfeeding. Otherwise, the law on drug testing newborns varies from state to state. 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). Katie Jane Fernelius The first case was adjudicated in 1977 and the last case in 2015. "Opioids are what we worry about most," he explained. The court held that the legislature did not intend for the relevant statute to apply to conduct during pregnancy that affected fetuses. Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. Dehumanizing Discourse, Anti-drug Law, and Policy in America: A "Crack Mother's" Nightmare . "Georgia Supreme Court Orders C-Section Mother Nature Reverses on Appeal." . Healthy pregnancies are essential for the well-being of mothers, infants, families and communities. Yet despite the country's best efforts to fight it, the problem is getting worse, and is exacerbated by the COVID-19 pandemic. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Ct. App. "Among newborns exposed to opioids in utero, between 55 percent and 94 percent develop withdrawal signsand 30 to 80 . 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. 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. Clear evidence suggests that recognizing the substance exposed infant and . Y.N., 104 A.3d 244 (N.J. 2014), Late-Onset Sex Offending and the Assessment of Behavioral Variant Frontotemporal Dementia (bvFTD), Factors Associated with Successful Completion of Juvenile Mental Health Court, by The American Academy of Psychiatry and the Law, https://www.guttmacher.org/statecenter/spibs/spib_SADP.pdf/, http://www.tennessean.com/story/opinion/contributors/2014/05/10/tennessee-voices-drug-use-pregnancy-epidemic/8914401/, http://wpde.com/news/videos/regina-mcknight-released-from-prison/, 2017 American Academy of Psychiatry and the Law. 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. 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. Such inhumane responses to drug use can only exist because they are almost exclusively reserved for poor people and people of color. Will you help us fight back with facts? Quitting tobacco can be hard, but it is possible. 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. Reproductive rights are under attack. Tennessee is the only state with a statute that specifically makes it a crime to use drugs while pregnant. DRH presents state and national estimates of marijuana use among pregnant women. Hence, health care providers should select relatively safe drugs. 1. In totality, medical expertise seemed to play relatively little role in determining the outcome of most judicial decisions. 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. 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. Both stand to undermine the medical treatment of pregnant women with substance use disorders and potentially increase harm to mothers and children. Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. 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. The report also found that Kentuckys child protection agency was not making enough efforts to prevent removal or re-entry to foster care. The new requirements become effective on July 1, 2007 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Priority applies to pregnant people referred for treatment. 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. 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. The groups listed below help people with drug abuse. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. 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. 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. 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. In Alabama and South Carolina, high courts have interpreted existing child endangerment and chemical endangerment statutes to allow prosecution of drug-using pregnant women and new mothers. 1991), People v. Hardy, 469 N.W.2d50 (Mich. Ct. App. She was charged with chemical endangerment of a child. We reviewed legal decisions regarding women charged with a crime against a fetus or child as a result of substance use during pregnancy. As of 2018, 38 states had . Although the legal bases for appellate court decisions varied (see Table 1), the functional outcome was that the charges were dismissed (n = 14) or convictions overturned (n = 11) for 86.2 percent of the women (25/ 29). Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. In order to to avoid the risk of withdrawal and possibly harming her fetus, M. did what many pregnant women in her situation do she continued to use illicit opioids. Kentucky ranks amongst the last in the nation in rates ofchildhood poverty. 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. 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. NAS is a group of withdrawal symptoms that most commonly occurs in newborns after exposure to opioids during pregnancy.If you are pregnant and using opioid pain medications, CDC recommends you talk to your provider before starting or stopping any medications to help you understand all of the risks and make the safest choice for you and your pregnancy. His girlfriend is also a meth addict. When she visited him, she was distressed to find he often had seemingly untreated rashes. 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 examined only published cases, almost all of which were appellate level decisions. Neonatal exposure to some drugs during pregnancy can have harmful effects on development and may lead to acute adverse events, including neonatal abstinence syndrome (NAS) and infant mortality. The underlying legal question considered in the judicial decisions in these cases is whether, for the purpose of adjudicating the criminal charges, a fetus is a child. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. Contributions are tax deductible to the fullest extent allowable. Support ProPublica's award-winning investigative journalism. Maternal deaths in the United States are increasing. At least in theory, legislatures could amend criminal laws to make clear that they intend them to apply to prenatal conduct that affects fetuses. Aspartame. As part of CDCs efforts to prevent overdoses and substance use-related harms, CDC is taking specific actions to prevent opioid use disorder among pregnant women and women who could become pregnant and to make sure women with opioid use disorder get proper treatment.