Evidence for Supportive Prenatal Substance Use Policies

Punitive approaches may be associated with unintended adverse pregnancy outcomes

Increased prevalence of illicit substance use during pregnancy in the past decade has renewed national attention to prenatal substance use policies (PSUPs).

Currently, there are punitive policies that criminalize drug use during pregnancy or define prenatal substance use as child maltreatment in child welfare statutes. If newborns are found to have prenatal exposure to substances or are born with neonatal abstinence syndrome, these states may charge the pregnant person with substance use disorder with child abuse or terminate their parental rights.

In contrast, states that adopt supportive policies provide pregnant women with priority access to substance use disorder treatment programs, as well as create or fund targeted substance use disorder treatment programs for pregnant women. Supportive treatments are recommended by American College of Obstetricians and Gynecologists to build trust and connections with the health care systems.

Some prenatal substance use policies date back to the 1980s, when states adopted measures that were intended to reduce adverse maternal and newborn health outcomes during the crack cocaine epidemic. Despite the limited body of research assessing the effectiveness of these policies, PSUPs have grown more punitive over time.

New publications authored by CHERISH Research Affiliates Angélica MeinhoferJohanna Catherine MacleanAli Jalali, and Shashi Kapadia, and CHERISH investigators Yuhua Bao and Jake Morgan evaluate the effectiveness of PSUPs on newborn health and analyze the impact of PSUPs on maternal outcomes among populations with opioid use disorder. The findings from these studies provide evidence that punitive PSUPs are potentially harmful and supportive PSUPs can have positive effects.

Prenatal Substance Use Policies and Infant Maltreatment Reports

Takeaway 1

Authors Johanna Catherine Maclean, Allison Witman, Christine Piette Durrance, Danielle N. Atkins, and Angélica Meinhofer led a study to examine the effects of punitive and priority treatment prenatal substance use policies on infant maltreatment reports. Read more here.

Prenatal Substance Use Policies and Newborn Health

Takeaway 2

Published in Health Economics, Angélica Meinhofer, Johanna Catherine Maclean, Allison Witman, and Yuhua Bao suggest supportive approaches may be more effective for improving perinatal health. Read more here.

Impact of Prenatal Substance Use Policies on Commercially Insured Pregnant Females with Opioid Use Disorder

Takeaway 3

Published in the Journal of Substance Abuse Treatment, Nadia Tabatabaeepour, Jake Morgan, Ali Jalali, Shashi Kapadia, and Angélica Meinhofer found that supportive approaches may improve health outcomes among commercially insured pregnant females with opioid use disorder while punitive prenatal substance use policies may worsen health outcomes. Read more here.

The studies were supported by funding from the Robert Wood Johnson Foundation, Gerber Foundation, and National Institute on Drug Abuse. The study, “Prenatal Substance Use Policies and Newborn Health,” was published in Health Economics on April 20, 2022; “Prenatal Substance Use Policies and Infant Maltreatment Reports,” was published in Health Affairs in May 2022; and, “Impact of prenatal substance use policies on commercially insured pregnant females with opioid use disorder,” was published in the Journal of Substance Abuse Treatment on May 10, 2022.

This article originally appeared on the CHERISH website. 

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