Giving Compass' Take:

• Here are five comprehensive policy approaches that address the hurdles for maintaining maternal and child health in the opioid crisis. 

• Why is maternal and child health in a precarious position within the context of the opioid crisis? Can donors help spur policy change that will prioritize mothers? 

• Read about the case for expanding coverage to parents with opioid and substance abuse disorders. 

The increasing prevalence of opioid use in the United States has resulted in higher rates of opioid use during pregnancy, and higher rates of a transient pediatric withdrawal condition called neonatal abstinence syndrome (NAS). Fears of NAS have anchored national discourse on the opioid epidemic’s impact on children and have driven punitive responses in many jurisdictions. Currently, 24 states have policies that consider opioid use in pregnancy a form of child abuse, and three states have pursued criminal prosecution of women with opioid use disorder (OUD) in pregnancy.

These policy approaches are premised on placing the needs of the newborn against those of the parent: in fact, it is impossible to uncouple the immediate and long-term health of a child from that of the mother. OUD frequently predates pregnancy, and is often exacerbated by structural vulnerabilities such as poverty and lack of access to health care—factors that also undermine child health outcomes. Parents with untreated OUD are more likely to overdose, be incarcerated, or be separated from their children, but access to effective treatment is limited across the country.

An effective policy approach to addressing the needs of women and children impacted by the opioid crisis needs to confront three intersecting policy challenges: the inconsistent response to the national overdose epidemic, the politicized landscape of women’s reproductive health, and public mechanisms designed to protect children from maltreatment. In this paper, we propose that comprehensive policy approaches addressing these intersecting challenges be guided by the following principles:

  1. Follow evidence, not ideology.
  2. Expand attention to women, children, and families beyond NAS.
  3. Provide comprehensive women’s health services throughout the reproductive lifespan.
  4. Adopt supportive interventions, not punitive ones.
  5. Provide support to preserve family unity.

Read the full article about maternal and child health within the opioid crisis by N. Jia Ahmad, Joshua M. Sharfstein, and Paul H. Wise at Brookings.