Punishments Don’t Help Pregnant Women and New Mothers with Addiction | Center on Addiction

Punishments Don’t Help Pregnant Women and New Mothers with Addiction

Punishments Don’t Help Pregnant Women and New Mothers with Addiction


A consequence in the worsening opioid epidemic is the rising number of infants born with opioid dependence, also known as neonatal abstinence syndrome (NAS). NAS is a health problem associated with fetal exposure to opioids which can cause excessive crying, rapid breathing, and slow weight gain. Seeking solutions for this issue, lawmakers have imposed reporting requirements for newborns that were exposed to opioids in the mother’s womb. Though NAS is a legitimate concern, these reporting requirements are not having their intended consequence. In fact, they are detrimental to the wellbeing of mothers with addiction and their infants.

Punishing mothers leads to poorer health outcomes for babies. 

Lawmakers have argued that the goal of reporting requirements is to reduce substance use during pregnancy and connect pregnant women and new mothers to treatment services. Yet research demonstrates these types of measures are frequently punitive and counterproductive with regard to improving the health of mother and child.

Data show that any threat of punishment for drug use during pregnancy discourages women who use drugs from seeking prenatal care. Lack of prenatal care is a huge threat to the health and well-being of mothers and babies alike. Babies born to mothers who received no prenatal care are three times more likely to be born at low birth weight and five times more likely to die than those whose mothers received prenatal care. Prenatal care is especially important for women who have used drugs since it can significantly reduce the negative impact of drug use on the fetus. Women who receive prenatal care can also be effectively treated for addiction. 

Tennessee provides an illustrative example. In 2014, in response to high rates of NAS, the state passed a law that made drug use during pregnancy punishable by incarceration. The law, which has since lapsed, not only failed to reduce drug use and connect women to treatment, but also made pregnancy outcomes worse.

These laws disproportionally impact vulnerable women. 

Low-income women and women living in rural areas are more likely to be punished for drug use during pregnancy. Race plays a role as well. Studies have shown that hospital staff is more likely to screen women of color for suspected drug use and physicians are more likely to report such use to authorities, even though women of color are no more likely to use drugs than women from other ethnic or racial groups.

Cherisse Scott, the Founder and CEO of SisterReach, a reproductive justice organization based in Memphis, highlights that, “for women of color, black women in particular, these [kinds of laws] are public health barriers that we cannot afford.”

What we need to do.

Laws that seek to punish women for substance use during pregnancy are rooted in stigma and predicated on a belief that a pregnant woman who uses drugs is an unfit mother and should be punished. As Lynn Paltrow, lawyer and Founder of National Advocates for Pregnant Women states, “[punitive laws] do not increase compassionate care, nor do they address underlying problems.”

To help women and their babies, lawmakers need to abandon the idea that pregnant women struggling with addiction are criminals or bad mothers. Instead, we should face their drug use as the public health issue that it is, and move forward with programs that provide treatment and support – not punishments.

  Kristen Pappacena, MA

   Kristen is a Research Associate at Center on Addiction



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