Babies Suffer Under Punitive Policies for Maternal Drug Use (USA)

A sad pregnant woman sitting on a couch looking at a pill blister pack in her hand

by Elizabeth Hlavinka, Staff Writer, MedPage Today

Policies that punish pregnant women for disclosing substance use disorder (SUD) can have negative consequences for infants, according to a cross-sectional study.

In an analysis of eight states with varying degrees of reporting policies for maternal SUD, those that classified it as child abuse, considered it grounds for civil commitment, or otherwise criminalized it had significantly higher rates of neonatal abstinence syndrome (NAS) than those without such policies, reported Laura Faherty, MD, MPH, of the RAND Corporation in Boston, and colleagues.

Compared to the year before states enacted their policies, those that enacted punitive measures for maternal SUD saw rates of NAS significantly increase during year 1 of implementation (adjusted odds ratio [aOR] 1.25, 95% CI 1.06-1.46, P=0.007) as well as beyond 1 year (aOR 1.33, 95% CI 1.17-1.51, P<0.001), indicating that the policy had an immediate and sustained impact, the researchers wrote in JAMA Network Open. No significant increase was seen in states that only enacted reporting policies.

From 2003 to 2014, 46 neonates were born with NAS per 10,000 births in states without punitive policies. In comparison, those with punitive policies had 57 infants born with NAS per 10,000 births the first year a punitive policy was enacted and 60 per 10,000 births the year after implementation.

“We think these punitive policies are pushing women into the shadows,” Faherty told MedPage Today. “We’re very concerned they’ve stigmatized women with the chronic condition of addiction and there is data to show these policies discourage women from getting prenatal care and SUD treatment that they really need both to keep themselves healthy and to ensure the best possible start to their babies’ lives.”

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The opinions expressed in this post are those of the authors. They do not purport to reflect the opinions or views of the FASD Prevention Conversation Project or its members.


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