Prenatal drug exposure may also contribute to long-term behavioral effects and developmental deficits. 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. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. In other words, the key concern in the judicial decisions to date has turned on the courts' interpretation of legislative intent. Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. 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. 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. Katie Jane Fernelius Additional cases were identified by reviewing the cases cited in the initial set of cases and published literature, yielding an additional nine cases. A mother taking illegal drugs during pregnancy increases her risk for anemia, blood and heart infections, skin infections, hepatitis, and other infectious diseases. 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. 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. Drug Use During Pregnancy: Will CPS Be Involved? - Williams Law Group, LLC Illegal Drug Use and Pregnancy - Children's Hospital of Philadelphia Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. They also found that cocaine users were more likely to use alcohol or other drugs during pregnancy: 88 percent of pregnant cocaine users smoked, 80 percent consumed alcohol, 72 percent smoked marijuana, 14 percent used opiates and 9 percent used other illicit drugs. In three states Minnesota, South Dakota and Wisconsin women who use drugs during pregnancy can be involuntarily committed to a treatment program. Additional factors were relevant to the stated judicial rationale in at least some of the cases. 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. 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. Cocaine lingers in a fetus much longer than an adult and often 5-7 days after birth. Substance Abuse Reporting and Pregnancy: The Role of the - ACOG This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. You will be subject to the destination website's privacy policy when you follow the link. LEXIS 496 (Tenn. Crim. 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. Critics argue law will deter women from seeking treatment. Prescription Opioid Pain Reliever Use During Pregnancy, The US Opioid Crisis & Maternal Infant Health, Centers for Disease Control and Prevention. Published on September, 30, 2015 Across the country, hundreds of pregnant women and new mothers have been accused of child abuse or other crimes when they or their newborns tested positive for. 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. Drugs and Pregnancy - Department of Mental Health Wisconsin provides priority access to pregnant people in both general and private programs. Newborn Drug Testing Laws + Treatment For Mothers | Ambrosia Briefs from medical or public health organizations were submitted to the court in seven of the cases, all supporting the defendant's position. 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. And the scientific literature that suggests that substance use produces social cognitive deficits in parenting is in its infancy and rather underwhelming. 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. About Opioid Use During Pregnancy | CDC - Centers for Disease Control Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. Your doctor can play an important role in helping you quit, including giving advice and support with quitting and connecting you with other resources. 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. Opioid use disorder among pregnant women is a significant public health concern in the United States. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. Establishes requirements for health care providers to encourage and facilitate drug counseling. Laws on drug testing of infants and new mothers vary, but the stakes are always high. Urine screening remains the most commonly used method despite the limited period during which drugs can be detected. The use of prescription drugs during pregnancy, excluding supplements, in Ethiopia was high. To learn more about medication-assisted treatment for opioid use disorder and considerations in pregnancy, visit https://www.samhsa.gov/medication-assisted-treatment. This is a sad situation. 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. 38]. 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. 19 states have 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. 1 2005), Kilmon v. State, 905 A.2d 306, 314 (Md. Theresearchis also clear that the results of a drug test alone are not an appropriate proxy for determining parental fitness. Criminalizing Pregnancy: Policing Pregnant Women Who Use Drugs in the Abstract. Pregnancy - Department of Health 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. She had given birth approximately one year earlier to a child who had also tested positive for cocaine. 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. Webster v. Reproductive Health services: the AMA position, Prosecuting pregnant women for drug use during pregnancy: the criminal justice system should step out and the affordable care act should step up, People v. Morabito, 580 N.Y.S.2d 843 (N.Y. City Ct. 1992), Reyes v. Superior Court, 75 Cal. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. 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. Will you help us fight back with facts? Criminal Charges for Child Harm from Substance Use in Pregnancy 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. 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. Most states do not have a law that requires hospitals to test infants and new moms for controlled substances. Alabama's crackdown on pregnant marijuana users - al.com CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. You can also go to SAMHSAs Behavioral Health Treatment Services Locator. 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. Drug use during pregnancy is a severe problem worldwide because it exposes not only the woman but also her developing baby to harmful substances. 1. The laws can vary widely from state to state in terms of reporting requirements and consequences of reporting. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Support ProPublica's award-winning investigative journalism. They help us to know which pages are the most and least popular and see how visitors move around the site. These same legislators would be hard-pressed to take babies away from mothers who were struggling with medical treatment for hypertension or diabetes. 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. 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 report pays particular attention to the impact of the 'chemical endangerment' law in Alabama, the state that has carried out the most prosecutions against pregnant women; and Tennessee's 'fetal assault' law, which between 2014 and 2016 made it a crime to give birth to a child showing symptoms of drug exposure. 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. Mar 02, 2022. In other instances, where medical expertise was referenced, it did not necessarily support the defendants' position. 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. 2023 Guttmacher Institute. 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. Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. 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. 31]. 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. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Anonymous screening of consecutive urine samples testing positive for pregnancy from a UK inner-city clinic demonstrated that approximately 16% of the women had taken one or more illicit substances (Sherwood et al, 1999). Stopping your medication suddenly could be harmful for you and your baby. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. Across the country, hundreds of pregnant women and new mothers have been accused of child abuse or other crimes when they or their newborns tested positive for controlled substances. 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. They have 1 child together that was born prematurely due to her drug use. 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 Second, they claim that drug use during pregnancy is a reliable indicator of parental unfitness. However, fentanyl has also been manufactured illicitly, and its distribution is on the rise. Learn more at Alcohol Use in Pregnancy from the Division of Birth Defects and Infant Disorders. 1995), State v. Dunn, 916 P.2d 952 (Wash. Ct. App. Here is a survey of state laws. -- A Tennessee woman is the first to be charged under a new state law that specifically makes it a crime to take drugs while pregnant . My distant cousin is a meth addict. 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. 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. 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. Unless otherwise noted, you can republish our stories for free if you follow these rules. The following information can help you understand [] 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. Using illegal drugs while pregnant can cause many complications to the baby including brain damage, premature birth, low birth weight and even fetal death. Several methods of drug testing are efficacious in identifying and monitoring drug use during pregnancy. Marijuana & Pregnancy: Top Studies | CannaMD The Center houses the Emory Neurodevelopmental Exposures Clinic (ENEC), a multidisciplinary clinic dedicated to providing evaluation and intervention services to individuals exposed to substances in pregnancy. 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. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. 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. Rapidly detecting fetal exposure to licit and illicit drugs is of considerable medical value. Detection of drug use during pregnancy - PubMed Drug addiction is a serious problem, especially when the drug addict is pregnant. 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. 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. 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. 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). 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. 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. Quitting tobacco can be hard, but it is possible. 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. App. Long-term effects of alcohol include: The baby being born with fetal alcohol syndrome (FAS) having symptoms, such as: Physical and facial abnormalities Learning disabilities, such as not being able to concentrate. Kentucky includes drug use during pregnancy as child abuse | Lexington The legal consequences of using drugs while pregnant 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. Quitline coaches can answer questions, help you develop a quit plan, and provide support. 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). Severalstudiesdocument that hospital staff disproportionately drug test and report to child protective services low-income women andwomen of color. Opioids are a class of drugs used to manage pain, but also have serious risks, such as addiction. 1991), People v. Hardy, 469 N.W.2d50 (Mich. Ct. App. 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. "Georgia Supreme Court Orders C-Section Mother Nature Reverses on Appeal." . The research that does claim to link substance use to maltreatment of children is not authoritative. Civil child abuse proceedings are explicitly permitted in 18 states.9 These may lead to termination of parental rights, but not to prison sentences. Using these drugs during pregnancy may affect your baby's growth and puts you at higher risk of miscarriage, early labour, and placental abruption, where the placenta comes away from the wall of the womb . Nicotine is a health danger for pregnant women and developing babies and can damage a developing babys brain and lungs. Using drugs while pregnant and addiction is a grave concern because it puts two lives at risk. Should Pregnant Women be Subject to Criminal Prosecution for For each case, we recorded the charges, the substance abused, neonatal outcome, legal resolution of the case, and judicial reasoning. More about medicines in pregnancy. Illegal drugs in pregnancy. 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. Apr 20, 2022, M. Forrest Behne, Craig Waleed, Meghan Peterson, and Lauren Brinkley-Rubinstein 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. Thank you for taking the time to confirm your preferences. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. Why Some Doctors Object to Tennessee Law That Criminalizes Drug Use Prescription opioids may be prescribed by doctors to manage moderate to severe pain. Ct. App. [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. 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 examined only published cases, almost all of which were appellate level decisions. Drug Use During Pregnancy Policies in the United States From 1970 to Neonatal abstinence syndrome . 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. You can review and change the way we collect information below. Before losing contact with her lawyer, M. told me her story via email. Pregnancy. " Among pregnant women aged 15 to 44, 5.4 percent were current illicit drug users based on data averaged across 2012 and 2013. Copyright 2023 by The American Academy of Psychiatry and the Law. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 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 This helps clinicians better understand the prevalence of marijuana use as they care for their pregnant patients and provide screening and treatment. She was charged with chemical endangerment of a child. Georgia drug possession laws treat the crime very seriously and a conviction for possession of even a small amount of an illegal drug can subject you to serious penalties. Criminalization of substance use during pregnancy because of harm to the fetus or child is fiercely debated. Eighteen states have laws that say drug use during pregnancy is child abuse. The overwhelming majority of parents prosecuted by the child welfare system are poor, and parents ofcolorare overrepresented. Future professional advocacy efforts may be most beneficial when directed at state legislatures that are dealing with proposed statutes that address these questions. In Minnesota and North Dakota, a test is required if there are drug-related complications at birth. However, in 2015, law enforcement cracked down on drug use during pregnancy. 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. Between 1992 and 1995, the number of states that prosecuted drug-addicted pregnant women increased nearly threefold. Such information can assist in making diagnosis of neonatal abstinence syndrome (NAS), as well as help clinicians focus the plan for treatment and follow-up for the neonates. Enter multiple addresses on separate lines or separate them with commas. If a woman is drinking alcohol during pregnancy, it is never too late to stop. Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. Using cocaine or methamphetamine -- also called speed, Tina, crank, or ice -- increases the risk of miscarriage early in the pregnancy. App. 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.