When laws meant to help babies might actually hurt them

A law was recently signed in the state of Tennessee that will allow pregnant women to be arrested and prosecuted if the babies they deliver are found to be harmed by any illegal narcotics mom took during her pregnancy. This law is the first of its kind to allow substance abuse to be grounds for child abuse charges in this fashion.

While I think we can all agree that in a perfect world, no pregnant woman should be using illegal narcotics, my gut tells me this law is not going to help their babies. In fact, it may lead to more harm.

Here’s how I see the situation playing out: Miss X is abusing heroin and realizes she is now pregnant. She wants to establish care with an OB/GYN, but she has heard about this law where she can be arrested if her baby is drug tested after she delivers and has any signs of withdrawal. Fearing this, she never sees a doctor and has no prenatal screening or counseling. She continues to use heroin. Had she seen a doctor, she could have been referred to a narcotic cessation and maintenance program. She goes on to deliver (at home) a preterm baby at 30 weeks, who suffers many complications. Miss X then leaves the state because of legal concerns, gives her baby up for adoption, and is pregnant again within the year because she didn’t have access to good healthcare or birth control.

Bad situation, right?

I think we need to carefully think this one out, and further consideration will show us this law isn’t going to solve the root of the problem: getting drug users the treatment they need. Pregnancy is a time in a woman’s life where she is much more likely to be healthy—especially because an unborn baby is a great motivator! For example, we know that almost 50 percent of women who smoke will quit once they find out they are pregnant.

The same goes for women abusing drugs. For many, a pregnancy is the final wake-up call to get clean and get into treatment. In fact, some programs that are very hard to get into will expedite treatment for pregnant women, and this may be the first time that a woman may have the chance to get true rehab treatment and counseling.

Therefore, criminalizing these women who desperately need this help—and their babies who need it even more—doesn’t make sense to me.

And where do we stop? Will we arrest pregnant smokers next? What about women who miss prenatal appointments? And those who don’t exercise? Sounds crazy, but it’s a slippery slope.

At the end of the day, we all want healthy moms and healthy babies. This law doesn’t address that, and only puts up more barriers to good prenatal care. Of course babies born to drug-abusing moms need extra attention: possibly being placed in alternative custody, involvement in appropriate follow-up, and good medical care.

But automatically putting a mother behind bars because she used an illicit drug at some point in her pregnancy and separating a mom from her baby based on a broad law without considering individual circumstances is not a sophisticated response. There are a lot of Miss X’s out there, and they need help.


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About Dr. Jennifer Lincoln, Medical Director, Pregnancy

Dr. Jennifer Lincoln is a generalist obstetrician/gynecologist and attending physician at a tertiary-care hospital in northeastern Pennsylvania. She spends the majority of her time on labor and delivery, but manages to fit in some outpatient clinic and operating time.


  1. Very eye-opening post.

  2. At first when I read this I thought the law sounded okay until I read the scenario. This could end very badly for both mommy and baby if the mom doesn’t get the medical care needed because she is too afraid to get arrested. Does this law state how long the mom will be in jail for? This may sound cruel but if the mom is only in jail for the remainder of her pregnancy I think this may be effective because it will force the mother to get clean and get the prenatal care she needs. I would like to think that if somebody is using and gets pregnant this would be the wake up call that will stop them from using but unfortunately, I think that a lot of women out there just don’t care and will continue to use regardless.

    1. I agree it’s the individual scenarios that I’ve seen that have made me think deeper about this. Not sure how it will play out regarding sentence length. I think the key is to keep in mind that jails are not treatment facilities, and many people who go in using come out using, especially because when they come out they have lost their jobs, have no support, and have no way to get a job if they have a record – truly it keeps the cycle going! Real drug/alcohol rehab is needed, and they work!, but they are rare because they cost more to run, sadly…


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