Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. His girlfriend is also a meth addict. Laws on drug testing of infants and new mothers vary, but the stakes are always high. Tennessee is the only state that has enacted a law that targets substance use by pregnant women on the basis of presumed harm to the fetus or child. We did not examine judicial decisions regarding women who have faced civil child abuse proceedings related to prenatal substance use. Additional factors were relevant to the stated judicial rationale in at least some of the cases. 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. In males, marijuana is thought to decrease sperm quality and testosterone levels. CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. 2015), The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida, Substance use during pregnancy and postnatal outcomes, Punishing pregnant drug users: enhancing the flight from care, Women's perspectives on screening for alcohol and drug use in prenatal care, Drug use and limited prenatal care: an examination of responsible barriers, Universal screening for alcohol and drug use and racial disparities in child protective services reporting, The American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women and American Society of Addiction Medicine, Committee Opinion No 524. The court held that the legislature did not intend for the relevant statute to apply to conduct during pregnancy that affected fetuses. Urine screening remains the most commonly used method despite the limited period during which drugs can be detected. Women charged with or convicted of crimes against their child or fetus related to substance use during pregnancy have won on appeal much more often than they have lost. Clear evidence suggests that recognizing the substance exposed infant and . Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. 1. International Perspectives on Sexual and Reproductive Health (19752020), Perspectives on Sexual and Reproductive Health (19692020). More mothers may soon know M.s pain. 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. Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. In Tennessee, this law carries a maximum penalty of 15 years in prison. The Center for MSACD also provides training, workshops, and other informational services concerning prenatal exposure to alcohol, nicotine, illicit drugs, and prescription drugs. Future professional advocacy efforts may be most beneficial when directed at state legislatures that are dealing with proposed statutes that address these questions. Second, they claim that drug use during pregnancy is a reliable indicator of parental unfitness. For example, onestudyfound that parents who use opiates find babies less cutewhile conceivably notable, this finding does not meet the legal standard for terminating a parents rights. If you are pregnant or trying to get pregnant and cannot stop drinking, get help. Disclosures of financial or other potential conflicts of interest: None. 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. 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. My distant cousin is a meth addict. Cookies used to make website functionality more relevant to you. Later in the pregnancy, these illicit drugs may cause. Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. Civil child abuse proceedings are explicitly permitted in 18 states.9 These may lead to termination of parental rights, but not to prison sentences. Additionally, e-cigarettes and other tobacco products containing nicotine (the addictive drug found in tobacco) are not safe to use during pregnancy. Such laws may discourage people from seeking prenatal care. LEXIS 496 (Tenn. Crim. 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. This claim also disregards the seriousgapsin access to treatment for substance use disorders, especially for poor people, and the absence of a social safety net to even support struggling families in the first place. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice System Should Step Out and the Affordable Care Act Should Step Up. Not coincidentally, in the aftermath of the 2008 financial crisis, as Arizonas social safety net shrank, its foster care numbers soared. 1995), State v. Dunn, 916 P.2d 952 (Wash. Ct. App. Eighteen states have laws that say drug use during pregnancy is child abuse. The child was placed with CPS and now is in the custody of the great grandmother. Mar 02, 2022. 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). 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. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. If you or someone close to you needs help for a substance use disorder, talk to your healthcare provider or call SAMHSAs National Helpline at1-800-662-HELP. Exposing how the U.S. criminal legal system fails to keep people safe and perpetuates harm. 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. Between 1992 and 1995, the number of states that prosecuted drug-addicted pregnant women increased nearly threefold. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby. Katie Jane Fernelius If youre using marijuana and are pregnant or are planning to become pregnant, talk to your healthcare provider. 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. 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. 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. Community after community has seen this in the aftermath oflocal crackdownson drug-using pregnant womenfewer women seek prenatal care and substance use treatment, even after the local authorities decide to change course. There were over 100,000 drug overdose . Both stand to undermine the medical treatment of pregnant women with substance use disorders and potentially increase harm to mothers and children. Federal Drug Laws. Learn more at Alcohol Use in Pregnancy from the Division of Birth Defects and Infant Disorders. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome (SIDS). In other words, the key concern in the judicial decisions to date has turned on the courts' interpretation of legislative intent. To view abstracts of recent publications in PubMed, see Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age and Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. They help us to know which pages are the most and least popular and see how visitors move around the site. If you or someone you know has a drug problem, seek help. Learn more about e-cigarettes and pregnancy. 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. Prescription Opioid Pain Reliever Use During Pregnancy, The US Opioid Crisis & Maternal Infant Health, Centers for Disease Control and Prevention. remove barriers to pregnant women with substance use disorders from getting evidence-based treatment that's tailored to their unique needs. July 14, 2014 -- Though the first mother has been charged under a new Tennessee law that makes it a crime to use drugs while pregnant, many of the most respected medical groups have opposed . For example, pregnant women should drink less than 1 liter (about 3 cans) of diet soda per day. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. The new requirements become effective on July 1, 2007 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. Only four states (North Dakota, Minnesota, Iowa and Kentucky) require hospitals to test both new mothers and their children if medical professionals suspect drug use. The infant was born prematurely. Significantly higher numbers come from the Centers for Disease Control, which in 2019 reported that some 16% of pregnant women . She struggled every day with the unimaginable pain and grief of separation from her newborn. [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. 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. When she visited him, she was distressed to find he often had seemingly untreated rashes. In Alabama and South Carolina, the majority of state supreme court judges determined that the plain meaning of the word child includes a fetus, or in their term, an unborn child.16,,18 In the other 17 states that considered the question, the opposite conclusion was reached: that is, a fetus is not a child in the eyes of the law in those jurisdictions. About half of the states treat drug use during. Otherwise, the law on drug testing newborns varies from state to state. LEXIS 970 (Tenn. Crim. The effects of illegal drugs, such as cocaine, can be devastating on a fetus. 38]. 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. To learn about CDC activities to prevent fetal alcohol spectrum disorders, visit About Us from the National Center on Birth Defects and Developmental Disabilities. Quitting early or before pregnancy is best, but its never too late to quit smoking. The research that does claim to link substance use to maltreatment of children is not authoritative. 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. Here is a survey of state laws. Cocaine lingers in a fetus much longer than an adult and often 5-7 days after birth. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. 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. 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. 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. Unless otherwise noted, you can republish our stories for free if you follow these rules. Establishes requirements for health care providers to encourage and facilitate drug counseling. 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. 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. 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. Because drug use during pregnancy can potentially harm a fetus, federal law requires state CPS agencies maintain a protocol for when babies are born with drugs in their system or showing drug withdrawals. Ct. App. 1994), Reinesto v. Superior Court, 894 P.2d 733 (Ariz. Ct. App. We do not know the role that medical expertise and testimony played in influencing the judicial outcome at the trial court level. Criminalization of substance use during pregnancy because of harm to the fetus or child is fiercely debated. State Responses to Substance Abuse Among Pregnant Women, Concerns Mount over Punitive Approaches to Substance Abuse Among Pregnant Women. Opioid use disorder among pregnant women is a significant public health concern in the United States. 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. Thus, it is not clear whether racial or economic bias is a factor in these cases. 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. Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. 2006), State v. Wade, 232 S.W.3d 663, 665 (Mo. A representative example of this due process reasoning was expressed by the court in State v. Martinez: To expand the ordinary meaning of this statute would deny Defendant reasonable notice that her actions were criminal, thereby violating her due process rights.39 Six courts held that allowing the contested statute to apply to prenatal drug use would in effect permit it to be applied to a range of prenatal conduct not previously considered illegal, in effect opening the floodgates to prosecution of pregnant women. 2023 Guttmacher Institute. Among pregnant women aged 15 to 44, the average . CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. 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. Fetal Assault Laws. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. Support ProPublica's award-winning investigative journalism. 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. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. 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. by Leticia Miranda, Vince Dixon and Cecilia Reyes Learn about the Division of Reproductive Healths efforts to address opioid use disorder to improve maternal and infant health. 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. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Opioid use disorder during pregnancy has been linked with serious negative health outcomes for pregnant women and developing babies, including preterm birth, stillbirth, maternal mortality, and neonatal abstinence syndrome (NAS). Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. 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. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. To learn more about medication-assisted treatment for opioid use disorder and considerations in pregnancy, visit https://www.samhsa.gov/medication-assisted-treatment. 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. The Tips campaign features information about how smoking and secondhand smoking affect specific groups, including pregnant women or women planning to have a baby. How you know. An official website of the State of Georgia. Studieshave found that babies exposed to cocaine in utero are not at greater risk of maltreatment as young children than similarly situated babies. Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. The mother was a drug addict. Kentuckyslegislation, which also became law last month, permits termination of a mothers parental rights if her newborn exhibits signs of withdrawal, known as neonatal abstinence syndrome, as the result of illicit opioid use, unless the mother is in substantial compliance with both a drug treatment program and a regimen of postnatal care within 90 days of giving birth. Georgia Marijuana Statutes First, they say the developing fetus and newborn will be harmed by prenatal exposure to illicit substances. 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. To date, the United States Supreme Court has declined to hear cases that raise questions about the constitutionality of such laws. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. Yet despite the country's best efforts to fight it, the problem is getting worse, and is exacerbated by the COVID-19 pandemic. 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. The groups listed below help people with drug abuse. The substances related to the charges included cocaine, heroin, methamphetamine, marijuana, and prescription pills. 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. There are several limitations to this study. Pregnancy. Illegal Drugs Marijuana (Cannabis) More research needs to be done on how marijuana use during pregnancy could impact the health and development of infants, given changing policies about access to marijuana, significant increases in the number of pregnant women seeking substance use disorder treatment for marijuana use, and confounding effects of polysubstance use. Before losing contact with her lawyer, M. told me her story via email. This helps clinicians better understand the prevalence of marijuana use as they care for their pregnant patients and provide screening and treatment. Dehumanizing Discourse, Anti-drug Law, and Policy in America: A "Crack Mother's" Nightmare . 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. 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. 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. 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. The federal Department of Health and Human Services recently released areportreviewing Kentuckys child welfare system. 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. 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. 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. 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. In females, there is evidence that marijuana use may disrupt the menstrual cycle. 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. We developed categories of relevant variables to code a priori. In many places, women lose their children or end up in behind bars, sometimes even if the drug was prescribed. 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.
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