The enactment of a Tennessee law that criminalizes substance abuse by pregnant women has made patients increasingly hesitant to pursue treatment for their drug addictions, according to Dr. Jessica Young, an obstetrician/gynecologist at Vanderbilt University Medical Center in Nashville, Tenn.
Tennessee’s law, which became effective in July, defines illegal narcotic use by pregnant women as assault, depending on whether the child is born addicted to or is harmed by the narcotic. A 26-year-old woman was among the first to be arrested in mid-July under the law.
"Since the new law was passed, women . . . often express a fatalistic attitude of, ‘Even if I do the right thing, I will be arrested or have my baby taken away,’ " said Dr. Young, who leads the Vanderbilt Drug Dependency Clinic for pregnant women.
The concern is that women will hide their addictions or self-detox at home, she said. "I think it will require some negative outcomes for this law to be struck down."
Physician associations, including the American Medical Association and ACOG, have long maintained that criminal punishment is not the answer to curbing drug abuse by pregnant women and that such laws create further harm to children. Fear of being reported to police was a primary reason women who abused drugs did not seek prenatal care, a recent study found (Am. J. Obstet. Gynecol. 2009;200:412.e1-10).
Laws that mandate criminal penalties against pregnant women who use drugs can significantly harm the physician-patient relationship, according to Dr. John M. Thorp, professor of obstetrics and gynecology at the University of North Carolina and director of women’s primary health care for UNC Healthcare, both in Chapel Hill.
These laws "put the physician or the clinic or hospital in the role of reporting the crime, which is completely the antithesis of wanting patients to be able to tell physicians what’s wrong with them and being able to offer treatment instead of punishment," Dr. Thorp said in an interview. "These laws are a real setback to the concept that substance abuse addiction is a disease, [and they are] another barrier for women seeking treatment."