Since the late 1980s, policymakers have debated the question of how society should deal with the problem of women’s substance use during pregnancy. Prosecutors have attempted to rely on a host of criminal laws already on the books to attack prenatal substance use. The Supreme Courts in Alabama and South Carolina have upheld convictions ruling that a woman’s substance use in pregnancy constitutes criminal child abuse. Meanwhile, several states have expanded their civil child-welfare requirements to include prenatal substance use, so that prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect. Further, some states, under the rubric of protecting the fetus, authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant women who use drugs; these policies sometimes also apply to alcohol use or other behaviors. A number of states require health care professionals to report or test for prenatal drug exposure, which can be used as evidence in child-welfare proceedings. And in order to receive federal child abuse prevention funds, states must require health care providers to notify child protective services when the provider cares for an infant affected by illegal substance use. Finally, a number of states have placed a priority on making drug treatment more readily available to pregnant women, which is bolstered by federal funds that require pregnant women receive priority access to programs.
State Policies on Substance Use During Pregnancy |
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SUBSTANCE USE DURING PREGNANCY CONSIDERED: |
WHEN DRUG USE DIAGNOSED OR SUSPECTED, STATE REQUIRES: |
DRUG TREATMENT FOR PREGNANT WOMEN |
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STATE |
Child Abuse |
Grounds for Civil Commitment |
Reporting |
Testing |
Targeted Program Created |
Pregnant Women Given Priority Access in General Programs |
Pregnant Women Protected from Discrimination in Publicly Funded Programs |
Alabama |
X* |
|
|
|
|
X |
X |
Alaska |
|
|
X |
|
|
|
|
Arizona |
X |
|
X |
|
|
X |
|
Arkansas |
X |
|
X |
|
X |
X |
|
California |
|
|
X |
|
X |
|
|
Colorado |
X |
|
|
|
Xξ |
|
|
Connecticut |
|
|
|
|
X |
|
|
Delaware |
|
|
|
|
|
X |
|
District of Columbia |
X |
|
X |
|
|
X |
|
Florida |
X |
|
|
|
X |
|
X |
Georgia |
|
|
|
|
|
X |
|
Illinois |
X |
|
X |
|
Xξ |
X |
X |
Indiana |
X† |
|
|
X |
X |
|
|
Iowa |
X |
|
X |
X |
|
X |
X |
Kansas |
|
|
|
|
|
X |
X |
Kentucky |
X |
|
X |
X |
X |
X |
X |
Louisiana |
X |
|
X |
X |
|
|
|
Maine |
|
|
X |
|
|
X |
|
Maryland |
|
|
|
|
X |
|
|
Massachusetts |
|
|
X |
|
|
|
|
Michigan |
|
|
X |
|
|
|
|
Minnesota |
X |
X |
X |
X |
X |
|
|
Missouri |
XΩ |
|
|
|
ξ |
X‡ |
X |
Montana |
|
|
X |
|
|
|
|
Nebraska |
|
|
|
|
|
|
|
Nevada |
X |
|
X |
|
|
|
|
New York |
|
|
|
|
X |
|
|
North Carolina |
|
|
|
|
X |
|
|
North Dakota |
X |
|
X |
X |
|
|
|
Ohio |
X |
|
X |
|
Xξ |
X |
X |
Oklahoma |
|
|
X |
|
|
X |
X |
Oregon |
|
|
|
|
ξ |
|
|
Pennsylvania |
|
|
X |
|
X |
|
|
Rhode Island |
X |
|
X |
X |
|
|
|
South Carolina |
X* |
|
|
|
X |
|
|
South Dakota |
X |
X |
X |
X |
|
|
|
Tennessee |
|
|
|
|
Xξ |
X |
X |
Texas |
X |
|
|
|
|
|
|
Utah |
X |
|
X |
|
|
X |
|
Virginia |
X |
|
X |
|
Xξ |
|
|
Washington |
X |
|
|
|
Xξ |
|
|
West Virginia |
|
|
|
|
|
XӨ |
|
Wisconsin |
X |
X |
X |
|
X |
Xᵝ |
|
TOTAL |
23+DC |
3 |
25+DC |
8 |
19 |
17+DC |
10 |
* The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. The South Carolina Supreme Court held that a viable fetus is a "person" under the state's criminal child-endangerment statute and that "maternal acts endangering or likely to endanger the life, comfort, or health of a viable fetus" constitute criminal child abuse.
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