Pregnant and Addicted:  A Chronic American Tragedy

June 16, 2019

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Imagine what it feels like to be pregnant and addicted, knowing your drug use is harming your baby, but you can’t stop.  Unfortunately, this tragedy deepens as these women are less likely to receive prenatal care or addiction treatment. Each day, the woman has to face the fact that her baby could be taken from her at birth, and she may end up serving time for her drug use. Sorrow and guilt replace the joy of bringing a new life into the world.  But, help is available for these women if they aren’t afraid to reach out.

We’ve heard stories about babies being born with Neonatal Abstinence Syndrome.  But, most of these infants recover and go on to live healthy lives.  However, in some cases, permanent damages occur in many of these children that affect their quality of life. As a result of the negative outcomes, many people contend that drug use during pregnancy constitutes child abuse. For this reason, many addicted pregnant women avoid prenatal care.  They are afraid their physician will report them to the authorities.  The fear is justified in many cases, due to the strict laws in some states against using drugs during pregnancy.

A Brief Survey of State Laws on Drug Abuse During Pregnancy

The laws on drug testing of infants and new mothers vary from state to state.  Let’s compare how different states view drug abuse during pregnancy.

These statistics are from 2015 and may have changed somewhat, but it will give you an idea of how the laws differ from one state to another:

  • Substance abuse during pregnancy as child abuse – Eighteen states have laws that say drug use during pregnancy is child abuse.
  • Substance abuse during pregnancy is a crime – South Carolina and Alabama allow prosecution of drug use during pregnancy. Tennessee is the only state that has statutes that make it a crime to use drugs while pregnant.
  • Testing only if suspected of drug use during pregnancy – Most states do not require hospitals to test infants and new mothers for drugs.  Only North Dakota and Minnesota require a test if drug-related complications arise at birth.
  • Prosecution of women for drug use while pregnant – Authorities in 45 states sought prosecution for women who expose their unborn child to drugs.
  • Health care workers required to report drug abuse during pregnancy – Health care workers in 15 states are required to report women they suspect of drug use while pregnant.
  • Grounds for civil commitment – Wisconsin, Minnesota, and South Dakota have laws that allow the involuntary commitment to a treatment program for pregnant women who are using drugs. In Wisconsin, women are detained until their child is born. The fetus has a court-appointed lawyer, and the woman can lose custody of the baby after its birth.

A more detailed look at how different states respond to drug use during pregnancy can be found on the ProPublica website.

Is It True That Babies Can be Born Addicted to a Substance?

Women who are pregnant and addicted are putting their infant’s health in jeopardy.  However, the child is not born an addict.  But, the infant will experience uncomfortable side effects immediately after birth due to the drugs in his or her system.  The child experiences withdrawal symptoms because the drug is no longer available through the umbilical cord.

Some of the withdrawal symptoms an infant experiences at birth can include irritability, tremors, fever, diarrhea, difficulty breathing or feeding, and seizures.  These infants will need 24/7 monitoring, and many of them remain in the hospital for several weeks.

Sadly, between 1999 and 2017, the number of NAS cases tripled.  About 6 out of every 1,000 newborns have NAS.

Can Women Who are Pregnant and Addicted Get Treatment?

No medications have been FDA-approved for treating opioid addiction in pregnant women. However, prenatal care combined with methadone maintenance and a comprehensive treatment program can help improve the outcome. This approach will result in the infant needing treatment for withdrawal symptoms due to methadone in their system. If the mother undergoes treatment with buprenorphine, it produces fewer NAS symptoms than methadone.  This results in shorter hospital stays for the infants.

Adverse health consequences of drug use during pregnancy are the primary reason that substance use during pregnancy and motherhood is a criminal justice and public health concern.  As a result, women avoid seeking prenatal care or addiction treatment because they don’t want to go to jail or have their baby taken away at birth. Many of these women also avoid friends and family who might report them to child protective services. At a time when she needs love and support, the woman finds herself isolated and living in fear.

Being pregnant and addicted, or drug use during pregnancy, is a growing problem across the United States.  Researchers continue to look for ways to improve the health outcomes for mothers and infants.

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