

Between 20, the incidence of NAS among hospital-born newborns increased from 1.20 to 3.39 per 1,000 live births per year. Some infants prenatally exposed to opioids exhibit symptoms of Neonatal Abstinence Syndrome (NAS), including hyperirritability and dysfunction of the nervous system, gastrointestinal tract, and respiratory system (Finnegan & Kaltenbach, 1992). A recent study found the rate of FAS in one Midwestern community to be 6–9 per 1,000 children, and more general Fetal Alcohol Spectrum Disorder (FASD) as high as 24–48 per 1,000 children (May et al. For example, the CDC website reports that the rate of Fetal Alcohol Syndrome (FAS) is 0.2-1.5 cases per 1,000 live births (CDC, 2014), although this estimate appears to be based on research from the 1990s. There are no reliable nationwide estimates of the annual number of infants born after prenatal substance exposure. Teenaged pregnant women have the highest rates of illicit drug use (15–17, 20.9%), followed by young adult women (18–25, 8.2%) and adult women (26–44, 2.2%). The rate of illicit drug use varies widely with the woman’s age. Of pregnant women aged 15–44, 5% report current illicit drug use, a proportion not significantly different than in the previous study year. The percentage of pregnant women in this age group who report smoking tobacco in the last month has not changed significantly in the last decade, while tobacco use among nonpregnant women in the same age group has decreased slowly but significantly each year. Of pregnant women aged 15–44, 17.6% report smoking tobacco in the last month, a figure that represents a small, nonsignificant increase from the 2009–20–2009 findings. 1990 Figdor & Kaeser, 1998 Murphy & Rosenbaum, 1999 Paltrow, 1999 Paltrow & Flavin, 2013 Roberts, 1991).įigures from the most recently-published report from the National Survey of Drug Use and Health (Substance Abuse and Mental Health Services Administration, 2012) state that, of pregnant women aged 15–44, 9.4% reported current alcohol use, 2.6% reported binge drinking, and 0.4% reported heavy drinking. Substance-using pregnant women, especially women of color and women in lower socioeconomic brackets, are subject to increased surveillance and may face arrest, prosecution, conviction and/or child removal (Banwell & Bammer, 2006 Boyd, 1999 Chasnoff et al. In addition, the past three decades have seen prenatal substance use become a criminal justice issue as the fetal protectionism movement spurred the increasing use of criminal sanctions for “deviant” mothers. The impact of their substance use on their personal health and the health of their fetuses is a public health concern, as professionals in this field are dedicated to improving maternal and infant health. Pregnant women who misuse substances (alcohol, tobacco, and prescription and illicit drugs) are positioned at the nexus of public health and criminal justice intervention. The implications of the findings are discussed, particularly the need for further expansion of treatment programs and social services to meet the needs of substance-using women. The findings suggest that policies that substance-using women find threatening discourage them from seeking comprehensive medical treatment during their pregnancies. Women described multiple barriers to treatment and healthcare, including a lack of suitable treatment options and difficulty finding and enrolling in treatment. Women’s stories highlighted their strategies for managing their risk of detection by health or criminal justice authorities, including isolating themselves from others, skipping treatment appointments, or avoiding treatment altogether. The three-part interview schedule included questions about past and current substance use, life history, and experiences with criminal justice authorities, child protective services, and health professionals. In-depth life history interviews were conducted with 30 recently-pregnant women who had used alcohol or other drugs during their pregnancies. This study explored the experiences of substance-using mothers as they navigated health and criminal justice consequences and accessed needed resources in the community. Negative health consequences associated with substance use impact both the mother and the developing fetus, and there are ongoing attempts to criminalize substance use during pregnancy that put pregnant substance-using women at risk of detection, arrest, and punishment. Substance use during pregnancy and motherhood is both a public health and criminal justice concern.
