An official website of the State of Georgia. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. We identified 24 judicial opinions published between 1977 and 2015 in cases involving 29 women prosecuted in 19 states. Aspartame. State Policies on Substance Use During Pregnancy. Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. (3) 1. 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. Using illegal drugs during pregnancy is dangerous for an unborn baby and the mother. 2005), Richards v. State, 2005 Tenn. Crim. CDC also works to better understand the association between marijuana use while pregnant with birth outcomes and postpartum experiences, such as depression and breastfeeding. Facts are largely determined at the trial level. State legislators, law enforcement officials, and physicians have struggled to reach consensus on how to identify, treat, and possibly punish women who abuse illegal substances during pregnancy. Criminal or civil penalties discourage women from seeking prenatal care they need for fear of having their drug use discovered, critics say. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. These same legislators would be hard-pressed to take babies away from mothers who were struggling with medical treatment for hypertension or diabetes. Illegal Drug Use and Pregnancy. Before sharing sensitive or personal information, make sure youre on an official state website. All types of alcohol are equally harmful, including all wines and beer. 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. As is true across the nation, rural areas have limited, if any, access to MAT. 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. 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. 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 Medical and public health authoritieswarn that women who fear losing their babies upon seeking medical care will bedeterredfrom seeking the care they need. Reyes was charged with two counts of felony child endangerment for her heroin use 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. "Complex Calculations: How Drug Use during Pregnancy Becomes a Barrier to Prenatal Care." . 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. Prenatal drug exposure may also contribute to long-term behavioral effects and developmental deficits. More mothers may soon know M.s pain. 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. 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. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. App. 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, Amanda Kimbrough's child was born prematurely and died shortly after birth, having tested positive for methamphetamine. Wisconsin provides priority access to pregnant people in both general and private programs. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Unless otherwise noted, you can republish our stories for free if you follow these rules. To date, the United States Supreme Court has declined to hear cases that raise questions about the constitutionality of such laws. Despite several phone calls to treatment providers in her county and surrounding counties, M. could not find a provider who was willing to accept her. The search yielded 77 published cases, of which, on closer review, 16 were found to be relevant. 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). Charges included child endangerment (n = 11), child abuse (n = 6), drug delivery (n = 4), attempted aggravated child abuse (n = 2), chemical endangerment of a child (n = 2), child neglect (n = 1), child mistreatment (n = 1), homicide (n = 1), manslaughter (n = 1), and reckless injury to a child (n = 1). 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. Tobacco and alcohol are the most commonly abused substances, followed by marijuana and cocaine. However, pregnant women with a disease called phenylketonuria shouldn't eat or drink aspartame. 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. 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. 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. All information these cookies collect is aggregated and therefore anonymous. Such laws may discourage people from seeking prenatal care. Question by Miss Crickett: Az law on drug use during pregnancy? Drug use during pregnancy is a severe problem worldwide because it exposes not only the woman but also her developing baby to harmful substances. In many places, women lose their children or end up in behind bars, sometimes even if the drug was prescribed. When she visited him, she was distressed to find he often had seemingly untreated rashes. Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. She had become dependent on opioids, but when she learned she was pregnant, she immediately tried to enroll in a medication assisted treatment (MAT) program. 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. In contrast, state legislatures could choose to preclude attempted efforts at prosecution with amendments that make explicit that existing laws are not meant to apply to prenatal conduct that may affect fetuses. Many substance use treatment centers do not offer MAT due to the stigma associated with it, and those centers that do provide MAT have not necessarily fulfilled their responsibility toprioritizepregnant women. Support a worker-led Appeal. Georgia Marijuana Statutes The infant was born prematurely. After the passage of the 2014 law, this reasoning no longer applied, although it became relevant again with the fetal assault law's expiration in July 2016. Through these efforts, the Center for MSACD continues to be a valuable resource to individuals, parents, and professionals in Georgia and the Southeast. Ct. App. App. We examined only published cases, almost all of which were appellate level decisions. In Kilmon v. State, the court said, 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. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. Studieshave found that babies exposed to cocaine in utero are not at greater risk of maltreatment as young children than similarly situated babies. Local, state, and federal government websites often end in .gov. The new requirements become effective on July 1, 2007 The federal Department of Health and Human Services recently released areportreviewing Kentuckys child welfare system. 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. 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. 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. 1977), State v. Gethers, 585 So.2d 1140, 1143 (Fla. Dist. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. In females, there is evidence that marijuana use may disrupt the menstrual cycle. 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. 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. 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. 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. LEXIS 496 (Tenn. Crim. 1. All of these cases were appellate decisions except for one published trial court decision,24 which we discuss separately, given that trial court decisions are not typically published and do not resolve matters of law. Charges included child endangerment, child abuse, drug delivery, attempted aggravated child abuse, chemical endangerment of a child, child neglect, child mistreatment, homicide, manslaughter, and reckless injury to a child. No adverse neonatal outcomes were reported in 41 percent of the pregnancies in this study. However, fentanyl has also been manufactured illicitly, and its distribution is on the rise. The other opinion33 that directly referenced medical literature did so to demonstrate the range of behaviors that are not legally proscribed (e.g., smoking, failing to obtain prenatal care) that are associated with poor neonatal outcomes. Prescribed medicines. 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. 31]. 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. More concerning, limited evidence suggests that punitive polices may deter women from prenatal care.49,,51 These policies also disproportionately affect minority and poor women.15,52 For example, in one study, black women who tested positive for substances at birth were reported to authorities at about 10 times the rate of white women, despite similar rates of substance use.47 Advocates of the punitive approach assert that drug courts can be used to compel treatment for pregnant women with substance use disorders. 2007), State v. Geiser, 763 N.W.2d 469 (N.D. 2009), Cochran v. Commonwealth, 315 S.W.3d 325 (Ky. 2010), State v. Stegall, 828 N.W.2d 526 (N.D. 2013), Arms v. State, 471 S.W.3d 637 (Ark. These cases typically involve significant civil matters, such as termination of parental rights or civil commitment to inpatient treatment facilities.55,56 There are instances where women have faced civil complaints for behavior that is consistent with current standards of care for medical treatment of addictions. 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. Opioids can be prescription or illicit. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. 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. 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. 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. M. thought she was doing the right thing. Priority applies to pregnant people referred for treatment. In jurisdictions where criminal charges are permitted, dispositions for convicted women should be treatment oriented. 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. 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. Proceedings resulted in dismissal of the charges or convictions overturned for 86.2 percent of the women. Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. 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.. In the family court systems, there is no respect for medicine or science, she wrote. A representative example is State v. Wade, where the court stated, The plain language of the child endangerment statute does not proscribe conduct harmful to fetuses.40 The courts typically made explicit that any ambiguity in the statutes must be construed liberally in favor of the criminal defendant. 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. To learn about CDC activities to prevent fetal alcohol spectrum disorders, visit About Us from the National Center on Birth Defects and Developmental Disabilities. Since the late 1980s, policymakers have debated the question of how society should deal with the problem of substance use during pregnancy. remove barriers to pregnant women with substance use disorders from getting evidence-based treatment that's tailored to their unique needs. 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. 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. 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). 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. A mother taking illegal drugs during pregnancy increases her risk for anemia, blood and heart infections, skin infections, hepatitis, and other infectious diseases. Neonatal abstinence syndrome . In other words, the key concern in the judicial decisions to date has turned on the courts' interpretation of legislative intent. It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. Indeed, Kentucky has one of the highest rates of child removal in the country. 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. State laws vary, but at least 23 states and the District of Columbia articulate that substance use during pregnancy is child abuse, and virtually every state in the U.S. will open an investigation (at the very least) into a person who tests positive for substances during or shortly after pregnancy. Federal Drug Laws. Stopping your medication suddenly could be harmful for you and your baby. Both stand to undermine the medical treatment of pregnant women with substance use disorders and potentially increase harm to mothers and children. Critics argue law will deter women from seeking treatment. Stakeholders should ensure safe prescribing practice for pregnant women through developin Later in the pregnancy, these illicit drugs may cause. Additionally, e-cigarettes and other tobacco products containing nicotine (the addictive drug found in tobacco) are not safe to use during pregnancy. You can also call 1-800-QUIT-NOW (1-800-784-8669) for free support. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby. Reproductive rights are under attack. Cases were decided by state supreme courts (n = 15) and state courts of appeals (n = 14). Apr 20, 2022, M. Forrest Behne, Craig Waleed, Meghan Peterson, and Lauren Brinkley-Rubinstein In Tennessee, this law carries a maximum penalty of 15 years in prison. Opioids are a class of drugs used to manage pain, but also have serious risks, such as addiction. This was lower than the rate among women in this age group who were not pregnant (11.4 percent). She told her treating physician about her opioid use during pregnancy, not realizing this could precipitate call to Child Protective Services (CPS). App. Heroin is an illicit opioid. Further, some states, under the rubric of protecting the fetus, authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant people who use drugs; these policies sometimes also apply to alcohol use or other behaviors. Using drugs while pregnant and addiction is a grave concern because it puts two lives at risk. Arizonaslegislation, which became law in April, permits termination of a mothers parental rights, either immediately when her newborn is born or within one year of her newborns birth, depending on how chronic the illicit drug use appears to the court. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 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. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Babies exposed to cocaine in the womb have a 25 percent increased chance of being born premature. Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. The substances related to the charges included cocaine, heroin, methamphetamine, marijuana, and prescription pills. 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.

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