LOS ANGELES -- Laws that punish women who abuse drugs during a pregnancy are often billed as a way to protect unborn babies from addiction. But new research finds they have the opposite effect: After states enact laws treating pregnant drug users as unfit mothers or criminals, the number of newborns who contend with drug withdrawal jumps significantly.
The new findings suggest that laws that criminalize a mother's drug use during pregnancy or threaten to remove newborns from their mothers' care discourage women from seeking addiction treatment and put their babies at greater risk of health problems from the moment they are born.
The study, conducted by experts at the Santa Monica-based Rand Corp., was published Wednesday in the journal JAMA Network Open. It comes as more states adopt laws against illicit drug users in a bid to reverse a burgeoning epidemic of addiction to opioid painkillers.
"These punitive policies are pushing women into the shadows," said study leader Dr. Laura Faherty, a pediatrician and health policy researcher. "It's shaming them from getting prenatal care and treatment for substance use disorder that they need to keep themselves and their babies healthy."
Faherty said it would be unthinkable to punish women for having epilepsy or diabetes during pregnancy.
"But we treat substance use disorder as a moral failing instead of the medical condition it really is," she said.
Between 1999 and 2013, the number of women in the United States with an opioid use disorder at the time of delivery quadrupled. The consequences for their babies can range from mild to dire: Whether a pregnant woman is taking prescribed opioids for pain, receiving low-doses of opioids as a treatment for addiction or abusing heroin, her newborn is likely to suffer neonatal abstinence syndrome -- essentially drug withdrawal -- in his or her first days and weeks of life.
While neonatal abstinence syndrome, or NAS, can be managed by pediatric specialists in a hospital, it is often agonizing for a newborn, and very costly. Infants born to mothers who took opioids can require weeks or months of hospitalization, during which the newborn may cry inconsolably and suffer tremors, convulsions and problems with breathing and feeding.
Across the United States, the rate of babies born with NAS rose fourfold from 2000 to 2014. Annual hospital charges for treating these young patients are about $1.5 billion.
It's not clear that a baby born with NAS will suffer long-term health risks. But the American College of Obstetricians and Gynecologists (ACOG) has noted that chronic untreated heroin addiction is linked to lack of prenatal care and a higher risk of fetal death, premature birth and low birth weight. Being born too early and/or too small can have lifelong consequences for a child's health.