states assist pregnant or postpartum individuals with substance use disorder in seeking help by having specific laws/regulations designed to help families with substance-exposed infants and not automatically considering substance use during pregnancy or giving birth to a substance-exposed infant to be child abuse or neglect, as of September 2023.
If a jurisdiction receives federal Child Abuse Prevention and Treatment Act (CAPTA) funds, it must have procedures in place that mandate a healthcare professional involved in the care or delivery of an infant affected by substance abuse or withdrawal symptoms to notify the state or local child welfare agency of the birth of such infant.CAPTA does not require the notification to contain any identifying information. CAPTA does, however, require that a family care plan be created for each infant for whom a notification is submitted.
Family care plans, also known as plans of safe care, are intended to be a non-punitive, collaborative, interdisciplinary, and responsive approach to ensuring the health and well-being of parents with substance use disorder (SUD) and infants born affected by parental SUD.When child safety is not a concern, family care plans offer a pathway for families to receive services and provide population-level tracking to increase resources to higher-need communities. These plans link families to services such as substance use, mental health or other medical treatment, peer support services, and social services.
Punitive approaches to substance use during pregnancy are harmful and ineffective
Punitive responses to substance use during pregnancy increase stigma, reinforcing the belief that pre-natal substance use makes an individual unfit to be a parent.Medication for addiction treatment (MAT), such as buprenorphine or methadone, is highly effective in improving the health of the pregnant individual and the fetus. However, only 19 states have created or funded drug treatment programs for pregnant people.
In addition, in 25 states, substance use during in pregnancy is classified as child abuseand may result in the removal of the child from the home. Research shows, however, that children placed into foster care have significantly worse health and well-being outcomes than children in similar situations who are not removed from the home.
Policies that criminalize, rather than treat, substance use during pregnancy also amplify other inequities. Black and Indigenous families are generally overrepresented in the child welfare system,and Black parents are less likely to be reunified with their children once removed from the home.
Supportive policies reduce family separation and encourage the use of more appropriate resources
Formal child protective services response pathways are often not tailored to the needs of substance-impacted families, and existing responses can often be ineffective. By creating separate pathways for families to access care through family care plans, states can reduce stigmatization and redirect individuals to more appropriate resources. Research also emphasizes the importance of keeping infants with the birthing parent immediately after birth and through infancy to improve short- and long-term outcomes.