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. Substance abuse reporting and pregnancy: the role of the obstetriciangynecologist, Board of Trustees, American Medical Association, Legal interventions during pregnancy: court-ordered medical treatments and legal penalties for potentially harmful behavior by pregnant women, Tennessee voices: drug use in pregnancy is an epidemic, Prenatal Drug Use/Criminal Offense S.B. Wisconsin provides priority access to pregnant people in both general and private programs. In other instances, where medical expertise was referenced, it did not necessarily support the defendants' position. Tobacco and alcohol are the most commonly abused substances, followed by marijuana and cocaine. Trainings on maternal substance abuse, child development, alcohol and other drug related effects are conducted for prevention providers. A newborn infant's death nearly 15 years ago is still causing a fierce legislative battle in Arizona and other states around the country. 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. Applying CDCs Guideline for Prescribing Opioids: Substance Abuse and Mental Health Services Administration: American College of Obstetricians and Gynecologists (ACOG) Committee Opinion: The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 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. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. 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. Prevalence of Current Substance Use Among Pregnant People in the US. 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. Using illegal drugs during pregnancy is dangerous for an unborn baby and the mother. The new requirements become effective on July 1, 2007 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. State Policies on Substance Use During Pregnancy. 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). An official website of the State of Georgia. Many of the early cases were related to maternal cocaine use, whereas more recent cases tended to involve maternal methamphetamine use. 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. 2005), Kilmon v. State, 905 A.2d 306, 314 (Md. 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. Studies show when a pregnant woman uses illegal drugs during pregnancy it can result in miscarriage, low birth weight, premature labor, placental abruption, seizures, respiratory problems, feeding difficulties, and death of the baby and the mother. Hence, health care providers should select relatively safe drugs. Narcotics Anonymous World Service Office in Los Angeles PO Box 9999 Van Nuys, California 91409 Telephone: (818) 773-9999 Fax: (818) 700-0700 Web site: www.na.org Substance Abuse and Mental Health Services Administration Ct. App. How you know. It is, however, not known how many women, if any, have been convicted at the trial court level and not had their case heard at the appellate level. This was lower than the rate among women in this age group who were not pregnant (11.4 percent). 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. International Perspectives on Sexual and Reproductive Health (19752020), Perspectives on Sexual and Reproductive Health (19692020). Drug use during pregnancy is a severe problem worldwide because it exposes not only the woman but also her developing baby to harmful substances. We identified 24 judicial opinions published between 1977 and 2015 in cases involving 29 women prosecuted in 19 states. 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. 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. Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. 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. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Three courts stated that permitting prosecutions under the contested statute was counterproductive to state policy goals and public health. Stopping your medication suddenly could be harmful for you and your baby. Georgia Marijuana Statutes 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. 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. "Complex Calculations: How Drug Use during Pregnancy Becomes a Barrier to 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. Such laws may discourage people from seeking prenatal care. Illegal drugs in pregnancy. The use of prescription drugs during pregnancy, excluding supplements, in Ethiopia was high. Although this may be the case, the medical care mandated by many drug treatment courts falls well below the standard of care required for some pregnant women.53,54, Of note, the cases loosely reflect epidemiological trends in patterns of drugs of choice. If you regularly use drugs, it's important to tackle this now you're pregnant. Prosecutors have attempted to rely on a host of criminal laws already on the books to attack prenatal substance use. The report also found that Kentuckys child protection agency was not making enough efforts to prevent removal or re-entry to foster care. 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. The mother was a drug addict. In females, there is evidence that marijuana use may disrupt the menstrual cycle. His girlfriend is also a meth addict. The overwhelming majority of parents prosecuted by the child welfare system are poor, and parents ofcolorare overrepresented. As of 2018, 38 states had . 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. Subscribe to our newsletters for regular updates, analysis and context straight to your email. Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. For example, Amanda Kimbrough's child was born prematurely and died shortly after birth, having tested positive for methamphetamine. Nicotine is a health danger for pregnant women and developing babies and can damage a developing babys brain and lungs. 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. 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. Later in the pregnancy, these illicit drugs may cause. 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. 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. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. Cocaine lingers in a fetus much longer than an adult and often 5-7 days after birth. Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. The implication for medical experts is that advocacy efforts may be most useful when focused on state legislatures that are contemplating policies to reduce harms associated with prenatal substance abuse. 1996), State v. Aiwohi, 123 P.3d 1210 (Haw. While some papers estimate that 1-3% of birth defects are thought to be caused by medications taken during pregnancy, the authors could not find a source for this statement that was based on study d. Cookies used to make website functionality more relevant to you. "Georgia Supreme Court Orders C-Section Mother Nature Reverses on Appeal." . At least in theory, legislatures could amend criminal laws to make clear that they intend them to apply to prenatal conduct that affects fetuses. 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). There may be many more unpublished trial decisions, the dimensions of which we have no way of assessing. 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. Additional factors were relevant to the stated judicial rationale in at least some of the cases. Maternal deaths in the United States are increasing. 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. 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. 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. 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. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. Opioid use during pregnancy can affect women and their babies. Priority applies to pregnant people referred for treatment. 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. [I]t would be an anomaly, indeed, if the law were such that a pregnant woman who, by ingesting drugs, recklessly caused the death of a viable fetus would suffer no criminal liability for manslaughter but, if the child was born alive and did not die, could be imprisoned for five years for reckless endangerment [Ref. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. 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. Drugs with evidence of fetal harm were widely used. Otherwise, the law on drug testing newborns varies from state to state. 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. Proceedings resulted in dismissal of the charges or convictions overturned for 86.2 percent of the women. Will you help us fight back with facts? 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. For example, the court held in State v. Gethers that, fear of prosecution could deter pregnant drug abusers from seeking treatment for drug problems.26 Thus, all of the courts whose decisions functionally overturned convictions or dismissed charges did so on the basis of legislative intent, but varied with respect to additional supporting legal arguments. Eighteen states have laws that say drug use during pregnancy is child abuse. In Minnesota and North Dakota, a test is required if there are drug-related complications at birth. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. The city of Savannah decriminalized the possession of marijuana, effective July 1, 2018. The vast majority ofTemporary Assistance for Needy Families (TANF) funding, or federal welfare dollars meant to help the poor, is not spent on assistance to poor families, but rather on placing and keeping children in the foster care system. Urine screening remains the most commonly used method despite the limited period during which drugs can be detected. If you or someone you know has a drug problem, seek help. 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. But, for that matter, she could have been a pregnant alcoholic, causing fetal alcohol syndrome; or she could have been addicted to self abuse by smoking, or by abusing prescription painkillers, or over-the-counter medicine; or for that matter she could have been addicted to downhill skiing or some other sport creating serious risk of prenatal injury, risk which the mother wantonly disregarded as a matter of self-indulgence. 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. Wisconsin provides priority access to pregnant people in both general and private programs. The laws can vary widely from state to state in terms of reporting requirements and consequences of reporting. In Kilmon v. State, the court said, App. App. Several methods of drug testing are efficacious in identifying and monitoring drug use during pregnancy. In three states Minnesota, South Dakota and Wisconsin women who use drugs during pregnancy can be involuntarily committed to a treatment program. In the subsequent months, M. saw her son once a week at best. Studieshave found that babies exposed to cocaine in utero are not at greater risk of maltreatment as young children than similarly situated babies. 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. The number of pregnant women with opioid use disorder at labor and delivery more than quadrupled from 1999 to 2014, according to a recent CDC analysis. Reproductive rights are under attack. 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. The following information can help you understand [] *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. 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. 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. 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.