As more states move to legalize marijuana and there is a continuing battle to address this nation’s opioid crisis, there is also more attention being given to some of addiction’s most vulnerable victims, the children. In the case of unborn children, U.S. states have been attempting to address drug and alcohol misuse during pregnancy with a variety of policies.

A new study examines the scope of these various policies over many decades and how they impact moms-to-be. There are also further recommendations to address these issues as well as information about resources for addiction treatment during pregnancy.

The Dangers of Drug and Alcohol Misuse During Pregnancy

Substance misuse and abuse during pregnancy can be harmful to both the mother and her unborn child. Unfortunately, this occurs with relative frequency and has become a significant public health issue.

SAMHSA reports that, in 2012, about 8.5 percent of pregnant women in the U.S. drank alcohol and 5.9 percent used illicit drugs. Common drugs of misuse include marijuana, cocaine, prescription opioids, and tranquilizers.

Addiction is not only harmful to the mother who drinks or uses drugs, but also to her unborn child. Babies who are born to an addicted mother can suffer from a range of health consequences that vary depending on the drugs used. These can include significant withdrawal symptoms, breathing and feeding issues, seizures, and even death.

How States Have Addressed Drug or Alcohol Misuse During Pregnancy

Public health officials and policymakers have long recognized the harm associated with pregnancy and addiction. There have been laws and other policies put in place over the years to address these issues, both for the sake of the mother and the well-being of the child.

A recent study reviews over 40 years worth of state policies regarding drug and alcohol use during pregnancy. The study, conducted by researchers at the Pacific Institute for Research and Evaluation,  looks at how those policies have evolved over time as well as the differences between addressing drug versus alcohol misuse by a mother-to-be.

Researchers reviewed regulations and statutes in U.S. states that deal with alcohol and drug use by pregnant women. Policies legislated between 1970-2016 were reviewed, and included laws that dealt with:

  • Mandatory warning signs
  • Requirements to report proof of drug use during pregnancy to child welfare agencies, authorities, or a public health authority
  • Priority access to addiction treatment for pregnant women
  • Defining drug use during pregnancy as child neglect/abuse
  • Limiting toxicology tests as evidence of child or fetal harm in criminal prosecutions
  • Involuntary mandatory commitment of pregnant women to protective custody or treatment

In these key areas, the study issued several findings:

  • Since 1970, there has been a substantial increase in the number of states with one or more drug/pregnancy policies in place.
  • As of 2016, there are 31 states with punitive policies or policy environments that are mixed, 12 states with supportive policies, and eight states with no policies.
  • In states with punitive policies, the most widely used laws require reporting to CPS followed by defining drug use while pregnant as child abuse/neglect.
  • Environments for drug use and pregnancy have become less supportive over time, with few states today having only supportive policies.

Regarding alcohol misuse during pregnancy, the study’s key findings included:

  • The most widely found alcohol pregnancy policies are supportive.
  • There are few states that provide priority alcohol treatment for pregnant women or for women with children, which is a recommended supportive policy.

What Has Been the Impact of State Policies on Moms-to-Be?

When reviewing these policies, researchers found that there were different types of regulations. Specifically, there were policies that were meant to punish pregnant women by either controlling their behavior or providing penalties. There were also supportive policies that sought to educate, intervene as early as possible, and provide addiction treatment services to pregnant mothers.

When reviewing the impact of these policies, researchers have shown that more punitive policies also tend to deter pregnant women from seeking both addiction treatment and prenatal care. These policies also disproportionately impact women of color.

Pregnant woman looking distressed

If drug or alcohol misuse during pregnancy is an issue, there is qualified addiction treatment available.

Further Recommendations for Addressing Pregnancy and Addiction

The authors of this study concluded several things about the types of policies used by different states, their effectiveness, and what actions could have a greater impact on pregnant mothers and their unborn children. First, punitive policies may act as a deterrent for some, but the overall effect is negative. In other words, pregnant mothers who are going to drink or use drugs will often avoid getting prenatal care, which can worsen health outcomes.

Second, there simply are not enough supportive policies among the states. Many pregnant mothers do not want to harm their unborn child and would welcome addiction treatment help. If this is available without fear of retribution, there is a greater chance that they will take advantage of the services.

Finally, the authors of the study point out that general alcohol and drug policies appear to benefit pregnant women and their children. For example, a policy that addresses opioid addiction or alcohol consumption in the general population is also going to have a positive impact on birth outcomes.

The Availability of Addiction Treatment During Pregnancy

Because substance use during pregnancy affects both the mother and her child, it is vital that addiction treatment is provided by qualified and trained professionals. While there is no single method for effective addiction treatment during pregnancy, having access to a wide range of resources is essential.

Substance use during pregnancy often occurs alongside a co-occurring disorder such as depression, anxiety, or an eating disorder. At The Recovery Village, we offer comprehensive addiction treatment services that include co-occurring disorders treatment when needed.

If you are pregnant and need help with a substance use disorder, contact us today to discuss your options for admission.

Pregnancy and Addiction: A Decades-Long Look at the Impact of State Policies on Moms-to-Be
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