Hayley Keith


Imagine an emergency room full of patients waiting to be seen. Some of which are in pain, some in distress, and some show no signs of physical or mental ailment whatsoever. What goes unnoticed is the pregnant woman in the corner who hides under a blanket of shame and guilt. She is an addict and her addiction will soon destroy the life of her unborn child if help is not found. Every year in the U.S. over 30,000 babies are born physically dependent on drugs. This number may continue to increase if proper resources are not available to pregnant addicts.

A sad reality in addiction is, using alcohol or drugs throughout a pregnancy exposes not only the mother, but also her developing child to the negative impact of such behavior. The long-term repercussions of drug use on exposed fetuses can be absolutely devastating. For this reason, seeking help is imperative for any pregnant woman who is addicted to any substance. Receiving professional assistance can often be a challenging endeavor. Pregnant clients are frequently turned away from drug rehabilitation centers and other facilities when their pregnancy is discovered. One can imagine the fear and anxiety brought on by social perceptions that label addicts as abusive parents and criminals.

Legal Repercussions
Pregnant addicts nationwide are afraid to seek help. Many believe that disclosing their addiction will have negative ramifications, such as judgement from their family and peers as well as legal repercussions.

During the past few years, expectant mothers have been arrested and jailed in New Hampshire, North Dakota, Missouri, Georgia, Colorado, Alabama, Arizona, New Mexico, and South Carolina based on claims that drug use implies child abuse. Women arrested for failing drug tests during pregnancy are not on drugs with the intention of harming their unborn child. With proper resources in place, struggling addicts could be given the opportunity to recover. Upon hearing such news stories, we can only assume that many women are hiding their problem and trying to deal with it alone, instead of seeking help.

Law enforcement agents and judges often justify their positions when arresting such individuals by stating they are helping to protect the children. It is obviously wise to remove a newborn baby from the custody of an addicted individual who cannot properly care for the child. Instead of criminally charging pregnant women, alternative options like rehabilitation should be made available to help erase the negative stigma surrounding mental illness and addiction.

Doctor-Patient Trust
Fear of judgment and confidentiality breaches can be a barrier
to pregnant women seeking care from their healthcare provider. The Health Insurance Portability and Accountability Act (HIPAA) protects patients from having their medical records disclosed to anyone outside of the patient-provider relationship. However, health care providers are mandated reporters, and subsequently are required by law to report suspicions of abuse or neglect. Seeking drug rehab is not a crime, but may be reported if the provider recognizes that there are children at risk in the care of the addict. The reporting of this suspicion does not directly lead to legal consequences, but legal action may be taken upon delivery of the baby if withdrawal symptoms are present and drug testing is found positive. For those reasons alone, addicts may intentionally choose not to disclose their drug usage when seeing their healthcare provider.

Opinion of Leading Organizations
Many leading health organizations have addressed this issue, such as The American Medical Association, The American Congress of Obstetricians and Gynecologists, The American Academy of Pediatrics and nonprofit organizations such as the March of Dimes.

All have concluded that the issue of drug and alcohol abuse among expectant mothers is a problem best addressed through appropriate rehabilitation therapy and education, rather than through the criminal justice system. If the threat of arrest is looming over a woman, she is much less likely to seek help and presumably envisions giving birth to a child in prison, a situation that is not uncommon.

Medical knowledge about dependency and addiction also demonstrates that the threat of arrest or jail time does not give a person enough incentive to discontinue drug use. In other words, fear and negative consequences are not motivators that stop an addict from using. For this reason, the threat-based approach of putting expectant mothers into the criminal justice system is merely an exercise in futility. Anything that holds a person back from seeking help is not an effective approach.

Stigma / Shame
In addition to feeling fearful, pregnant addicts often experience pain, shame, and guilt for introducing their addiction to the unborn child. Modern society has an idea that motherhood should be exciting, challenging, and of course drug free. For an addict, the pregnancy dream immediately turns into a nightmare. Pregnant addicts struggle to forgive themselves, which causes depression, emotional turmoil, and feelings of embarrassment. The journey to sobriety can help these women immensely, as they are given tools to help cope with the stress of motherhood and difficulties during recovery. However, finding proper help for a pregnant addict can be difficult.

Lack of In-House Facilities
As of 2015, a mere 19 states offer in-house substance abuse programs specifically for pregnant women. There are many reasons for this, including the ambivalence of the medical community regarding the best withdrawal medications, and the lack of provisions specific to pregnant individuals. In some cases, rehab facilities do not want to take on the liability of caring for an expectant mother who is simultaneously dealing with a substance abuse problem. Many rehab facilities are lacking in resources and may not have qualified clinical staff necessary to provide appropriate care for pregnant patients.

The sad fact is that few rehabilitation facilities offer programs for expectant mothers suffering from substance abuse. Fortunately, federal aid is available to certain patients who are willing to temporarily relocate to areas where treatment is available. There are also resources, such as Pregnant Addiction Solutions, which have treatment programs specifically designed for pregnant addicts. Ultimately, it is not only in the woman’s best interest to seek help, but also beneficial for the unborn baby. If we educate the public on the issue of pregnancy and addiction, we can reduce the stigma and raise awareness. Pregnant addicts need help from the treatment industry, not the justice system. We must treat pregnant addicts to prevent babies born into addiction and ensure all mothers have a chance to raise their child.

Hayley Keith is the outreach coordinator for Pregnant Addiction Solutions. In her capacity as a business development rep for a leading addiction treatment facility, Hayley saw that pregnant addicts were being turned away from treatment providers time and again with devastating consequences. She has helped pioneer treatment options for pregnant women that have achieved remarkable results. With continuous efforts she hopes to raise awareness, educate the public, erase the stigma, facilitate treatment for pregnant addicts, and change lives one day at a time.