addicted pregnant women in handcuffs

Every day in the United States a parent loses a child to meth and other addictive substances. For a majority of people; it would be unimaginable for someone to intentionally cause harm to the life of a child. While we recognize that America is fighting an epidemic of untold proportions; we seldom discuss the dirty little secret of addiction and pregnancy.

Being addicted and pregnant has become a reality for many women. Unfortunately, as the nation’s opioid crisis has risen, the demand on the treatment facilities for treating expectant mothers has also climbed. The treatment centers and physicians are struggling to keep up with the growing demand for services. Physicians and treatment facilities are also struggling to provide adequate treatment for both the expecting mother and simultaneously protecting the developing baby.


The legal system has become a problem for the unborn child. While they advocate for the apprehension of children from mothers of addiction; the system is driving away those who should be seeking treatment during pregnancy. The system has insisted that children of addiction be apprehended to protect them and to provide treatment during an extensive chemical withdrawal period.

The threat of a child being apprehended is a deterrent for a number of pregnant mothers seeking treatment. It is not only preventing mothers from seeking treatment for their addiction, but it is preventing them from seeking medical care during their pregnancy. Have we forgotten that addiction is a disease? Why are we, as  a society, threatening to apprehend a child from a mother who is struggling with a chronic illness?Have we lost our humanity? Why are we placing mothers and children into a legal system for a chronic illness?

The dirty little secret of drug addiction and pregnancy is the fuel that drives many addicts away from seeking care. Moreover, it is also the legal statute that frightens many well intended mothers from seeking treatment. Did you know that 24 states and the District of Columbia consider the use of illegal substances to be a violation of a child’s rights? In fact, if found abusing drugs during pregnancy, these same jurisdictions would consider this to be a blatant act of child abuse. Meanwhile, there are only a mere 19 states that have created or funded drug treatment facilities. Treatment centers designed to care and manage expectant mothers account for less than a quarter of the nation’s treatment centers.

“Oftentimes what I see is that we treat pregnant women even worse than we treat the general population with opioid use disorder,” said Stephen Patrick, a neonatologist and assistant professor at Vanderbilt University School of Medicine in Nashville. “We should be offering them more compassion.”


The legal system is causing a number of pregnant mothers to avoid care. While seeking care for the addiction is one side of the coin, on the flip side is the developing baby. The baby’s inability to receive care and be monitored throughout the process of development could increase the odds that the baby may be born with additional health defects. We already know that the probability of a baby being born with birth defects increases the longer a mother uses. Yet, we place mothers at odds with seeking treatment because of fear of apprehension and the legal repercussions. What are we trying to convey to mothers who are struggling with addiction? That you are less of a person because you have an addiction?

Obviously, not every addict is interested in the well-being and safety of their child. Arguably, nor are all non-users of addictive substances interested in the well-being and safety of their children. Frustratingly, we label expectant mothers as child abusers long before the child is even born. Upon the day that the child is expected the be delivered; we have social service workers ready to apprehend the child and take the child into custody. The child and mother are often not even provided a moment to bond. The mother, who has been struggling with a severe chronic illness, is now struggling with the same illness, as well as the emotional despair of loss.

As a clinician, I used to ask myself how could a mother knowingly use chemicals while pregnant, but I have realized that this is not always a clear cut and dry issue. For some addicts, the addiction is to mask an internal psychological struggle that they have fought throughout their precious lives. For other addicts, the addiction is to mask the scars of an abusive spouse or environment. Yet for others, they may have begun using due to inability to afford an opioid once prescribed by their physician. As many have discovered, the cost of opioids are not only increasing, but are becoming more difficult to receive in times of medical need. While we also realize that there are many who have chosen to use due to a selfish journey to feel high and free of this life, the truth is, addicts are all struggling, but our society rather label them as criminals than individuals with a severe chronic illness. Likewise, as a clinician, I have never met an addict who was not presenting with a comorbid issue.


The research concerning addictive mothers remains hopeful. According to a recent research study: “Perinatal substance use: a prospective evaluation of abstinence and relapse” found that 83 percent of pregnant mothers who were using a variety of substances were capable of ceasing use of the substance during pregnancy.

Further research suggests that mothers struggling with addiction are more likely to stay clean if they are allowed to interact and care for their babies. The forcible removal of a child from its mother will only exacerbate a mother’s substance abuse issue. Whereas, a mother who is given an opportunity to prove motherly has a higher likelihood of maintaining sobriety. Of course, we must also not neglect to provide adequate care and treatment for the addiction, as well as support systems for guiding a mother in childrearing.


Pregnancy is an exciting time for most mothers, even mothers who are dealing with a chronic substance abuse issue. Naturally, a mother’s instinct is to protect and prevent harm of her unborn child, but when dealing with a chronic substance issue; mothers are often at odds with the addiction and the pregnancy. Still, we know that addicts need special attention to help with addiction and the recovery process, but why do we insist on labeling them as abusive? Perhaps we need a different set of lenses when treating mothers who are addicted.

Perhaps we need to look at creating long term treatment facilities that allow mothers struggling with addiction to stay throughout the term of their pregnancy. Furthermore, we should consider helping not only the mother to overcome her addiction, but to help facilitate the natural bond between mother and child. Have we forgotten what is was to be a child and the attachment we may have been granted with our own mothers?

The addiction should not be an excuse to apprehend a child. Nor should a mother neglect her motherly instincts to achieve her next high. It is a moral conundrum. Do we allow a mother who has had a chronic history of substance abuse to be motherly? Do we forcefully remove a child from his or her mother due to a chronic illness? Where do we draw the line in the sand? What if a mother had an opportunity to not only achieve sobriety, but to prove unto herself that she had the capability of being motherly?

In the case of many addicts, the old African proverb is fitting: “it takes a village to raise a child.” Sometimes- it takes a village not only to raise a child, but to guide and encourage a woman into motherhood.

Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website:
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