In contrast, policies that fund treatment for prenatal substance use are associated with a 45 percent decrease in overdose deaths for pregnant women, and those that prioritize treatment access in cases of prenatal substance use are associated with more prenatal care use and healthier birth outcomes.
Research indicates that policies that require health care providers to test for prenatal substance use can foster inequitable treatment. For example, Black mothers can be more likely to be screened for substance use, regardless of patient history, and are no more likely to test positive than White mothers.
For additional perspective, we reached out to Dr. Anne Pylkas, MD, an addiction medicine physician. Dr. Pylkas said:
“I think the general consensus among treatment providers … is that we need to create better systems to support mothers with substance use disorder, both before and after birth, and that using legal/child protection consequences should be the option of last resort to protect the child. Obviously, the more we can engage mothers with treatment on their own terms, the better the outcomes will be, for both mother and child.”
State approaches to prenatal substance use vary widely and data show that certain policies are associated with either worse or better outcomes. Now that opioid settlement dollars are providing states a windfall, leaders must decide what to invest in. We hope their decisions are guided by achieving the best outcomes for children and families.
