Giving Compass' Take:

• Pediatrician Laura J. Faherty explains how research found that policies that punish pregnant women for substance use do not help women or infants. 

• How can policies be built to improve outcomes for infants and women? What role can philanthropy play in researching, advancing, and implementing more effective policies? 

• Learn how compassion lowers health risks for pregnant women with trauma.


As a pediatrician, I've cared for a lot of babies with neonatal abstinence syndrome, (NAS), which is a withdrawal syndrome experienced by some opioid-exposed babies after birth. I've had the privilege of getting to listen to some of their mothers at the bedside, while their babies remain in the hospital being treated for their symptoms. These mothers talk about their past traumas, their struggles with addiction, and their fears of losing custody of their children. I began to wonder how various state policies related to substance use in pregnancy were impacting these families outside of the hospital walls.

I learned that since 2000, the number of states with policies that punish women for substance use during pregnancy has more than doubled. About half of all U.S. states now have these policies, which criminalize substance use in pregnancy; consider it grounds for civil commitment; or consider it child abuse or neglect.

My colleagues and I decided to study this issue because, while these policies were becoming increasingly common, we were concerned that no one knew if they even worked. Our study looked at almost 5 million births in 8 states around the United States. Some of the states enacted these policies, and some states didn't. We found that instead of being associated with lower rates of NAS, in fact, more infants were born with drug withdrawal symptoms in states with policies that punish pregnant women for substance use. This was the case both immediately after the policy was enacted, and in the longer term.

In short, our research suggests that punitive policies aren't beneficial for infants or their mothers.

Read the full article about policies that punish pregnant women for substance use by Laura J. Faherty at RAND Corporation.