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Unmasked: Driving Pregnant Addicts Underground

Megan is six months pregnant, but has not seen a doctor or received any prenatal care for herself or her baby. Why? Megan is also an addict.
As a resident of Tennessee, she can be charged with felony abuse for birthing a baby who is addicted to drugs. For Megan, the result of this law is a fear of seeking healthcare in light of potential legal charges.

Unfortunately, Megan is not alone.

Good Intentions, Questionable Outcomes

Of course, the intention of the law is not to scare pregnant women away from healthcare. The goal is to encourage pregnant women who have a drug problem to seek help and to supply law enforcement officials with a method for addressing the problem via treatment programs.

As it’s written now, the law provides a built-in defense for women facing these charges:


Those charged can forego jail time by entering a treatment program before giving birth and successfully completing the program afterwards.


Despite good intentions, the law is not without its own adverse side effects. Pregnant women may avoid contact with medical professionals due to the fear of prosecution, meaning they will never receive help from the offered treatment programs. This care-deterrent factor has caused many organizations, including The American Medical Association and the American Society on Addiction Medicine, to oppose the creation of criminal laws in this particular area.

Does the Punishment Fit the Crime?

Some research suggests that the information we’ve been given on drug use during pregnancy and its effects on newborns is, at best, misleading.

Drug use during pregnancy has bad effects on newborns so mothers should take prenatal careWhile newborns exposed (prenatally) to illicit substances undoubtedly suffer consequences, other factors can contribute as well. Mothers of these infants often lack prenatal care and good nutrition. In fact, poverty issues seem to be the greatest negative contributor to infant health, as well as the mother’s drug use.

Research has indicated that women can have healthy pregnancies if they receive prenatal care and assistance with other issues – even if they can’t abstain from drugs completely. If this truly is the case, scaring women away from treatment with the threat of legal action may actually add to the number of unhealthy pregnancies and infants.

Alternatives to Jail Time

To avoid criminal charges, pregnant women must get clean and sober or at least demonstrate they are on the road to recovery. This means treatment. But, is it available?

Many drug treatment programs oppose a medication-assisted approach. However, this approach is favored by doctors, and is recommended during pregnancy. Going cold turkey can be extremely dangerous for the fetus.

Financial barriers also exist. As mentioned, many moms struggling with drug abuse are also battling poverty issues. This means costly treatments are usually not an option. Even if methadone treatment is available, it may not be covered by state or federal aid.

What’s a Mom to do?

The hope is that this law – and others like it – will ultimately result in healthier moms and babies. So far, however, the results are less than optimistic. In fact, there are a number of reports illustrating how addicted moms are seeking out alternatives to avoid legal repercussions.

Methods have generally included the following:

  • Fleeing the state
  • Giving birth alone
  • Attempting detox alone
  • Avoiding all forms of prenatal care

Obviously, none of the options above are healthy, nor are they desired outcomes of the law. There has to be some kind of middle ground; we need initiatives that focus on the health of unborn children and their mothers. And no matter the language of the law, the central focus must be addiction treatment.

Additional Reading: What are Addiction-Related Developmental Delays?

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