Pregnant, Addicted and Fighting the Pull of Drugs

 Addiction remains one of the world’s most stigmatized medical conditions. Among people who use drugs, pregnant women may be the most scorned.

That condemnation is pervasive throughout the criminal justice system. In the child protection system, agencies routinely take custody of newborns who test positive for drugs but do not then usually offer support services to the mother. According to a May study in Obstetrics and Gynecology, those removals were associated with a greater likelihood that the women would more quickly become pregnant again and that those fetuses would have an increased risk of exposure to drugs in the womb.

That stigma is also deeply ingrained in health care itself. Many providers, surveys show, view the women as selfish and morally flawed.

Pregnant women who use drugs often delay prenatal care or avoid it entirely, medical experts say, afraid that their doctors will report them to the child welfare authorities. Most detox centers will not accept pregnant women, fearing that if the fetus is harmed, the facility could be held liable.

...

With illicit fentanyl dominating the drug supply and use of meth and other addictive substances soaring, the need for programs like this one has only become more urgent. The National Institute on Drug Abuse reported in November that overdose deaths in pregnant and postpartum women rose sharply in 2021, compared with 2018, with rates more than tripling for women ages 35 to 44. In 2022, 204,000 pregnant women, or nearly 10 percent of the national total, reported using illicit drugs, including cannabis, in the previous month, according to federal data.

Their children have paid a price. Drug-related deaths in babies under a year old have risen sharply, according to a new study in The Journal of Perinatal Medicine. Newborns and infants are the fastest-growing group in foster care, according to a 2022 report by the White House Office of National Drug Control Policy. Parental drug misuse was cited in a third of cases in which a child was removed from the home.

The complex needs of pregnant drug users are gaining acknowledgment in medicine. Some hospitals, including those in Boston, Chapel Hill, San Francisco, Philadelphia, Las Vegas and Tampa offer programs with obstetric care and addiction treatment. Skeptical administrators initially viewed these clinics as enabling addiction. But in just the first year of the Great Moms clinic, prenatal care visits rose by 120 percent.

Pregnant, Addicted and Fighting the Pull of Drugs - The New York Times (nytimes.com)