USA: Pregnant women with substance use disorders need treatment, not prison

More than 210,000 women spent Mother’s Day 2019 in America’s prisons and jails.

Two-thirds of them are mothers of young children; an unknown number are pregnant. Many of them have substance use disorders with a significant history of trauma and mental health problems. Some have been incarcerated solely for the alleged crime of substance use during pregnancy, and many have lost custody of their children because there aren’t enough treatment centers for women and their kids.

Pregnant women with substance use disorders inside and outside of prisons and jails are struggling, and many are dying. The 2017 National Survey on Drug Use and Health found that 1 in 12 pregnant women had used an illicit drug in the past month. Recent reviews of maternal causes of death in three U.S. states identified opioid overdose as a significant contributor to maternal deaths, between 11% and 20% of all deaths during pregnancy. The number of newborns with neonatal abstinence syndrome has increased 300% in 28 states in the last 20 years.

Ongoing threats of criminal and punitive civil child welfare actions against this group of women with substance use disorders are feeding the most enduring and deadly barrier they face: fear. The policy of punishment has suppressed women’s disclosure of their substance use problems and kept them out of prenatal care and social services when early therapeutic approaches can help them recover and provide support to their families.

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