Giving Compass' Take:

• Laura J. Faherty and Bradley D. Stein report that punishing pregnant women for substance discourages them from seeking healthcare, increasing the number of infants being born with opioid withdrawal.

• How can funders work to improve outcomes for pregnant women and their children? 

• Read about the role for philanthropy in addressing the opioid crisis. 

State policies that impose punitive action against pregnant women who use illicit substances are associated with higher rates of infants being born with opioid withdrawal, suggesting policymakers should instead focus on public health approaches that bolster prevention and expand access to treatment, according to a new RAND Corporation study.

Researchers found that infants born in states with punitive policies such as considering drug use as a form of child abuse were more likely be born with a withdrawal syndrome experienced by some opioid-exposed infants after birth (neonatal abstinence syndrome) than those born in states without punitive policies. The association was observed both shortly after the policies were enacted and over the longer term.

Policies that require the reporting of prenatal substance use—which may result in a referral to drug treatment or other intervention—were not associated with higher rates of neonatal abstinence syndrome. The study, published by the journal JAMA Network Open, examined nearly 4.6 million births in eight states from 2003 to 2014.

“Our findings are consistent with other studies showing that policies that penalize pregnant women for substance use deter them from seeking necessary health care,” said Dr. Bradley D. Stein, senior author of the study and director of the RAND Opioid Policy Tools and Information Center. “Disengaging from the health care system poses risks both for pregnant women and their infants.”

Read the full article about punishing pregnant women for substance use by Laura J. Faherty and Bradley D. Stein at RAND Corporation.