1996), State v. Aiwohi, 123 P.3d 1210 (Haw. Otherwise, the law on drug testing newborns varies from state to state. Drugs with evidence of fetal harm were widely used. Using illegal or street drugs during pregnancy, including cannabis, ecstasy, cocaine and heroin, can have a potentially serious effect on your unborn baby. 1 These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. 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. Convictions were upheld only in Alabama and South Carolina, involving a total of four women. 1991), People v. Hardy, 469 N.W.2d50 (Mich. Ct. App. 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. 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. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Heroin is an illicit opioid. Subscribe to our newsletters for regular updates, analysis and context straight to your email. Hair has been recognized as a possible alternate test specimen, but wider acceptance of hair testing must await . 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. Stopping your medication suddenly could be harmful for you and your baby. 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. As her due date approached, M. found a hospital that claimed to specialize in the care of babies who were exposed to opioids in utero and traveled a far distance to give birth there. In all of the cases, the judicial decision depended on the disposition of the question of whether, for the purpose of adjudicating the criminal charges, a fetus is a child. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome (SIDS). At the present time, the Center for MSACD fulfills several roles in Georgia by sponsoring clinical, prevention, and research programs. Federal drug laws exist to control the use, manufacturing, possession, and distribution of various drugs that are legal and illegal. 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. Rapidly detecting fetal exposure to licit and illicit drugs is of considerable medical value. If youre using marijuana and are pregnant or are planning to become pregnant, talk to your healthcare provider. 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. Second, they claim that drug use during pregnancy is a reliable indicator of parental unfitness. -- 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 . The Florida Supreme Court found the medical testimony inadequate to support the trial court's finding that a delivery occurred during the birth process, even if the criminal statute had been applicable.29 In Arms v. State, Arms was also convicted of a drug delivery charge that was overturned by the state supreme court, in part on the grounds that the relevant statute, does not expressly criminalize the passive bodily processes that results in a mother's use of a drug entering her unborn, or newborn child's system.45. LEXIS 970 (Tenn. Crim. Here is a survey of state laws. 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). 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. Dr. Appelbaum is Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law, Department of Psychiatry, Columbia University, and Director, Division of Law, Ethics, and Psychiatry, Columbia College of Physicians and Surgeons, and NY State Psychiatric Institute, New York, NY. There were over 100,000 drug overdose . If you regularly use drugs, it's important to tackle this now you're pregnant. 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. 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. Facts are largely determined at the trial level. 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. Quitting smoking is one of the most important ways you can protect your health and the health of your baby. Sign In to Email Alerts with your Email Address. App. Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. 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. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. Kansas and Nebraska have no reporting or testing requirements, the survey says. 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). His girlfriend is also a meth addict. Criminalization of substance use during pregnancy because of harm to the fetus or child is fiercely debated. An official website of the State of Georgia. Illegal drugs in pregnancy. Civil child abuse proceedings are explicitly permitted in 18 states.9 These may lead to termination of parental rights, but not to prison sentences. 2007), State v. Hudson, 2007 Tenn. Crim. Indeed, Kentucky has one of the highest rates of child removal in the country. 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. Tennessee is the only state with a statute that specifically makes it a crime to use drugs while pregnant. In many places, women lose their children or end up in behind bars, sometimes even if the drug was prescribed. Exact terminology for relevant crimes varies across states and broad inclusion criteria were used for initial case review. Not coincidentally, in the aftermath of the 2008 financial crisis, as Arizonas social safety net shrank, its foster care numbers soared. More mothers may soon know M.s pain. Urine screening remains the most commonly used method despite the limited period during which drugs can be detected. There may be many more unpublished trial decisions, the dimensions of which we have no way of assessing. 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. Fentanylis a prescription opioid that can be used to treat severe pain. 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. 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. Proceedings resulted in dismissal of the charges or convictions overturned for 86.2 percent of the women. Future professional advocacy efforts may be most beneficial when directed at state legislatures that are dealing with proposed statutes that address these questions. 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. 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). Copyright 2023 by The American Academy of Psychiatry and the Law. The following information can help you understand [] One local news source investigated Poolaw's case in conjunction with 45 other pregnant women across the state charged with felony child abuse, neglect, or manslaughter in relation with substance use since 2017. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. The child was placed with CPS and now is in the custody of the great grandmother. This means that first-time offenders will be issued an infraction (like a speeding ticket) instead of jail, with a maximum fine of $150. Briefs from medical or public health organizations were submitted to the court in seven of the cases, all supporting the defendant's position. The city of Savannah decriminalized the possession of marijuana, effective July 1, 2018. 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 mother was a drug addict. Theresearchis also clear that the results of a drug test alone are not an appropriate proxy for determining parental fitness. 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. 2023 Guttmacher Institute. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . 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. There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. We examined only published cases, almost all of which were appellate level decisions. Thus, it is not clear whether racial or economic bias is a factor in these cases. We did not examine judicial decisions regarding women who have faced civil child abuse proceedings related to prenatal substance use. 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. A number of states require health care professionals to report or test for prenatal drug exposure, which can be used as evidence in child-welfare proceedings. It often relies on caseworker-confirmed reports of child maltreatment, despite thewell-documentedpropensity of caseworkers and family courts to base findings of child neglect on evidence of drug use alone. 1995), State v. Dunn, 916 P.2d 952 (Wash. Ct. App. 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. In that way, this legislations attempt to punish mothers and fathers acts as a civil death penalty for families, for which children will pay the ultimate price.. These cookies may also be used for advertising purposes by these third parties. 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). Good reproductive health policy starts with credible research. 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. You will be subject to the destination website's privacy policy when you follow the link. Severalstudiesdocument that hospital staff disproportionately drug test and report to child protective services low-income women andwomen of color. Stakeholders should ensure safe prescribing practice for pregnant women through developin Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. 488. first criminal charges brought against a woman for using drugs during pregnancy came in 1977 against Margaret Reyes. Her infant tested positive for cocaine shortly after birth. A recent addition to the Center is Mother To Baby Georgia, a service providing evidence-based information to women about exposures to medications and other substances during pregnancy. Fifteen states have laws requiring health care workers to report to authorities if they suspect a woman is abusing drugs during pregnancy. All information these cookies collect is aggregated and therefore anonymous. Priority applies to pregnant people referred 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. An obvious example is the recent Tennessee law that explicitly made illicit drug use during pregnancy a form of criminal assault. We also identified judicial references to expert or fact witness medical testimony and to medical literature or medical or public health-related amicus briefs. 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. Trainings on maternal substance abuse, child development, alcohol and other drug related effects are conducted for prevention providers. There are several limitations to this study. 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. Question by Miss Crickett: Az law on drug use during pregnancy? 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. 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. While the findings varied dependent upon county, across the board, only 18 received any kind of rehab/treatment for drug abuse as . Arizona's legislation, which became law in April, permits termination of a mother's parental rights, either immediately when her newborn is born or within one year of her newborn's birth, depending on how chronic the illicit drug use appears to the court. 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. She told her treating physician about her opioid use during pregnancy, not realizing this could precipitate call to Child Protective Services (CPS). Mar 02, 2022. Yet despite the country's best efforts to fight it, the problem is getting worse, and is exacerbated by the COVID-19 pandemic. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. Before losing contact with her lawyer, M. told me her story via email. Critics argue law will deter women from seeking treatment. Quitting tobacco can be hard, but it is possible. 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. The laws can vary widely from state to state in terms of reporting requirements and consequences of reporting. At least in theory, legislatures could amend criminal laws to make clear that they intend them to apply to prenatal conduct that affects fetuses. More about medicines in pregnancy. 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. Enter multiple addresses on separate lines or separate them with commas. The state argued that the drug delivery occurred via the umbilical cord in the period after birth but before the cord was clamped. 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. Opioid abuse, dependence, and addiction in pregnancy, Medication assisted treatment in US drug courts: results from a nationwide survey of availability, barriers and attitudes, Maternal-fetal rights and substance abuse: gestation without representation, Pregnant women and the use of corrections restraints and substance use commitment, New Jersey Division of Child Protection & Permanency v. App. In other words, the key concern in the judicial decisions to date has turned on the courts' interpretation of legislative intent. Kentucky ranks amongst the last in the nation in rates ofchildhood poverty. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby. 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. In the subsequent months, M. saw her son once a week at best. As of 2018, 38 states had . An official website of the State of Georgia. 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. 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. Cases wherein charges resulted in civil proceedings only (e.g., custody proceedings) were not included. Those unable to pay may perform community service instead. An example of this reasoning was articulated by the majority in State v. Welch: Saving Lives, Protecting People, https://www.samhsa.gov/medication-assisted-treatment, prevent overdoses and substance use-related harms, Learn about the Division of Reproductive Healths efforts to address opioid use disorder to improve maternal and infant health, CDC Guideline for Prescribing Opioids for Chronic Pain, A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders, Opioid Use and Opioid Use Disorder in Pregnancy, Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and their infants, Final Report: Opioid Use, Misuse, and Overdose in Women, What We Can Do About Opioid Use Disorder in Pregnancy, SAMHSAs Behavioral Health Treatment Services Locator, guidance from the American College of Obstetricians and Gynecologists, What You Need to Know About Marijuana Use and Pregnancy, The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (2017), Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. 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. Exposing how the U.S. criminal legal system fails to keep people safe and perpetuates harm. App. However, pregnant women with a disease called phenylketonuria shouldn't eat or drink aspartame. In males, marijuana is thought to decrease sperm quality and testosterone levels. Nicotine is a health danger for pregnant women and developing babies and can damage a developing babys brain and lungs. 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. Arizona now has one of the highest foster care placement rates in the nation. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. Since the late 1980s, policymakers have debated the question of how society should deal with the problem of substance use during pregnancy. 1. Through these efforts, the Center for MSACD continues to be a valuable resource to individuals, parents, and professionals in Georgia and the Southeast. Learn about the Division of Reproductive Healths efforts to address opioid use disorder to improve maternal and infant health. 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. The first case was adjudicated in 1977 and the last case in 2015. Before sharing sensitive or personal information, make sure youre on an official state website. The Tips campaign features information about how smoking and secondhand smoking affect specific groups, including pregnant women or women planning to have a baby. 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. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. 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 2014, Tennessee made national news when it became the first state in the country to pass a law specifically making it a crime to use drugs while pregnant. 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 Quitting early or before pregnancy is best, but its never too late to quit smoking. However, fentanyl has also been manufactured illicitly, and its distribution is on the rise. The Supreme Courts in Alabama and South Carolina have upheld convictions ruling that an individuals substance use in pregnancy constitutes criminal child abuse. Criminal or civil penalties discourage women from seeking prenatal care they need for fear of having their drug use discovered, critics say. 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.