Her Body, Her Rights

thumb.phpLast week, Governor Bill Haslam of Tennessee signed a bill that would allow criminal charges against women who struggle with drug dependency during their pregnancy. This will make Tennessee the first state to authorize the filing of assault charges against a mother if it is determined that she has harmed her fetus or newborn with illegal narcotics. With Tennessee being one of the top states that have the highest infant mortality rate and babies born with neonatal abstinence syndrome (NAS), one may think this bill would receive a lot of praise and positive reactions. Proponents of the bill believe that it will help to decrease the amount of babies born with NAS, the infant morality rate, and also encourage drug-abusing mothers to seek help. However, many opponents of this new bill claim that will it do more harm than good, and I have to agree with them. This bill will not benefit the women or their babies of Tennessee; rather it will discourage the mothers from seeking the necessary prenatal care and addiction counseling in fear of going to prison, thus increasing the infant mortality rate and babies born with NAS even more so.

According to the Tennessee Department of Health Statistics, the number of babies born with neonatal abstinence syndrome (NAS) over the past ten years has increased immensely. NAS is characterized by a group of problems that occur in a newborn that was exposed to addictive illegal or prescription drugs while in the mother’s womb. Some symptoms include: blotchy skin, excessive sucking, poor feeding, rapid breathing, and seizures. Last year, in a little over nine months, more babies were born dependent on the drugs their mothers took than in all of 2012 in the state of Tennessee. By the first week of October, 643 babies were born dependent, compared to 629 for all of 2012. Tennessee Health Department’s Commissioner John Dreyzehner stated, “At the current rate this epidemic is progressing, we are projecting more than 800 drug dependent newborns by the end of this year.” The most current TennCare costs for a healthy newborn are $4,237, whereas average costs for an infant born drug dependent, diagnosed with NAS, are $66,973. These statistics alone should be enough evidence to project the harsh reality that Tennessee faces when it comes to infant mortality rates and remains as incentives for the government to take action.

In an effort to combat those statistics and help expectant mothers who abuse drugs, Congress implemented the Safe Harbor Act last year that offers treatment to pregnant women addicted to prescription and illegal drugs. Under the Safe Harbor Act, pregnant abusers of prescription drugs no longer risk losing custody of her newborn if they seek treatment and certain requirements are met for the remainder of the pregnancy. The Act states that if the attending obstetrical provider determines before the end of the 20th week of pregnancy that the patient is abusing prescription drugs, which may place the fetus in jeopardy, the provider must encourage counseling, treatment and discuss other assistance with the patient. Rather than the Department of Child Services taking the newborn and other children away or putting the mother behind bars, the incentive was to get women treatment or into rehabilitation centers to help them get their lives back on track.

However, the recent bill stands in sharp contrast to the Safe Harbor Act. Proponents of the newest bill believe that the Safe Harbor Act did not go far enough in reducing rates of babies born with NAS or punishing pregnant abusers. Tennessee State Representative Terri Lynn Weaver stated, “Here’s the double standard. If I hit a lady who’s pregnant and they’re both [mother and fetus] killed, that’s two counts of homicide. But a woman who is pregnant can stab herself in the stomach and hurt her baby and not be charged with anything. The Safe Harbor Act made a woman who was pregnant above the law.” Weaver introduced the newest bill to the House in hopes to end the rising epidemic of babies born with neonatal abstinence syndrome and to “properly punish mothers who harm their unborn fetuses.” What’s interesting though, is that Weaver claimed, “that infants born with NAS ‘look like Gerber babies but their whole mechanics are twisted, and they’ll never be the same.’” But, according to Dr. Kathy Hartke of the American College of Obstetricians and Gynecologists (ACOG), that’s not medically accurate. Not only are the effects of NAS temporary, “there are excellent treatments for it,” Hartke stated. So, if the effects of NAS are known to be temporary and there are excellent treatments available, why did Gov. Haslam sign such a criminalizing law?

Governor Haslam was given 10 days to decide whether or not he was going to veto or sign the bill into law, wherein he “had extensive conversations with experts including substance abuse, mental health, health and law enforcement officials.” Haslam stated, “The intent of this bill is to give law enforcement and district attorneys a tool to address illicit drug use among pregnant women through treatment programs. I understand the concerns about this bill, and I will be monitoring the impact of the law through regular updates with the court system and health professionals.” Despite his statement of “understanding,” Haslam went against the warnings from major medical associations such as The American Medical Association, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, that measures criminalizing pregnant women will only discourage them from seeking prenatal care and drug treatment. SisterReach, a Tennessee-based reproductive justice group, made concerns regarding the bill expressively clear to Governor Haslam. “Despite our advocacy attempts and regardless of the impact this law will have on marginalized families; despite the danger that medical professionals have noted a law of this magnitude will cause, our governor chose his party over the experts,” SisterReach founder and CEO Cherisse A. Scott said in a statement.

Several problems could potentially arise due to the passing of the bill and they were all mentioned to Governor Haslam during the 10-day debating period. The American College of Obstetricians and Gynecologists’ (ACOG) official view is to oppose legal actions that criminalize pregnant women’s behavior towards their fetuses. ACOG states that, “Incarceration and the threat of incarceration have proved to be ineffective in reducing the incidence of alcohol or drug abuse.” Herein lies the first and perhaps the most obvious problem the bill will cause for pregnant women and their babies: If pregnant women become fearful that their doctors might find evidence to have them arrested, they will be less likely to seek out the medical care they need during a pregnancy. Another major problem with Tennessee’s proposed law is that it ignores the fact that legally prescribed narcotics can also result in NAS. Dr. John Dreyzehner of the Tennessee Department of Health states that, “In Tennessee we know that 60 percent of the babies born to mothers, the babies that develop Neonatal Abstinence Syndrome, their mothers had a prescription for the medication they were taking.” The bill states, “that a woman may be prosecuted for an assaultive offense for the illegal use of a narcotic drug while pregnant, if her child is born addicted to or harmed by the narcotic drug and the addiction or harm is a result of her illegal use of a narcotic drug taken while pregnant.” Tamar Todd, senior staff attorney for the Drug Policy Alliance, stated, “The reality is that many women use alcohol, tobacco, or other drugs while pregnant. But only a few are prosecuted and only for using certain drugs — not those drugs shown to pose greater possible risk to fetal health, such as alcohol.” Todd points out the obvious fact that babies, whose mothers abuse legal narcotics, have just as much of a chance of being born with NAS as those whose mothers abuse illegal street drugs. It seems as though Governor Haslam didn’t take into consideration this evident information that will result in a disadvantage for mothers living in poorer neighborhoods.

Opponents of the new law also share a concern that a lack of access to health care and treatment facilities will result in the disproportionate targeting and jailing of poor mothers and mothers of minorities, particularly in rural districts throughout the state. Many critics of the bill believe women belonging to these groups will be charged in greater numbers, demonstrating an unfair approach to “punishment.” Republican State Senator Mike Bell, one of the seven Republicans in the State Senate who voted against the measure, stated that the lack of access is a problem that he thinks will hurt the women of his district and their families. Bell stated, “I represent a rural district. There’s no treatment facility for these women there, and it would be a substantial drive for a woman caught in one of these situations to go to an approved treatment facility. Looking at the map of the state, there are several areas where this is going to be a problem.” Only 19 out of the Tennessee’s 177 addiction facilities offer addiction care specifically for pregnant women and only 2 allow other children to be present while their mother is being treated. Governor Haslam also refused the Medicaid expansion, leaving many lower class women without reliable access to basic medical or prenatal care. With such little access to the proper medical and prenatal care pregnant women require, and the idea that the bill will unfairly target women living in deprived neighborhoods, it is no wonder that there are so many critics of the new law.

Although other states have been prosecuting women who use drugs during their pregnancy for many years, Tennessee will become the first state to allow criminalization against these women for up to 15 years. More likely than not, the bill will definitely ensue fear in expectant mothers, causing them to shy away from the help they need. I am in no way condoning drug use during pregnancy, but I don’t believe that women should be imprisoned for it. Drug abusers need support in order to get better and this law will discourage help. Governor Haslam’s motives for the bill seem good-hearted, but the fact that he went against the recommendations of various medical professionals and health advocacy groups makes one second-guess his intentions. I truly hope that this bill will improve the lives of many Tennessean women and their babies, but after reviewing all of the criticisms, it seems more detrimental than beneficial.

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