Doctors applaud end of Tenn.’s fetal-assault law

Associated Press

NASHVILLE, Tenn.

Brittany Hudson was pregnant, addicted to painkillers and afraid of a Tennessee law that calls for the arrest of mothers of drug-dependent babies. She eventually gave birth without medical help, on the side of a road in the foothills of the Great Smoky Mountains.

Hudson’s dilemma, doctors say, was one of many unintended consequences of the Tennessee Legislature’s decision in 2014 to become the first and only state with an explicit criminal offense for these addicted mothers.

The law was meant to deter drug abuse by threatening mothers with up to a year behind bars, while allowing them to avoid jail and have their assault convictions removed if they got drug treatment. It was also an experiment with a “sunset” clause, meaning it will expire this July because the law’s supporters lacked the votes to extend it.

The problem of drug use and pregnancy is worsening nationwide, with a drug-dependent baby born every 25 minutes in the U.S. at a cost of $1.5 billion in additional health care, according to a Vanderbilt study. And states can’t just arrest their way out of it, said Dr. Stephen Patrick, a neonatologist who co-authored the study.

But doctors who treat addicts say Tennessee’s experiment backfired, encouraging women to avoid prenatal care and exposing their babies to more risks while failing to reduce the astronomical costs of treating newborns who suffer from drug withdrawal – what doctors call neonatal abstinence syndrome, or NAS.

“As soon as the law was passed, very quickly I started to see women with drug addictions seeking prenatal care later and later in their pregnancies and seeking treatment for their addiction later in pregnancy,” said Dr. Jessica Young, who runs an outpatient program for pregnant addicts at Vanderbilt University Medical Center.

“And what they would tell me is that they would attempt to self-detox at home, attempt to stop at home without any treatment because they were afraid of what would happen if they admitted they had a problem,” Young said.

The law was meant to help women get treatment and hold them accountable for child abuse, said its sponsor, Rep. Terri Lynn Weaver, a Republican who still believes it had a positive impact. She dismisses the evidence as anecdotal and says there isn’t enough data to show women were avoiding treatment. She wonders what will happen now.

“Who is going to be the voice of these babies?” she said.

It’s not clear how many women have been arrested, in large part because the law created no new reporting obligations on the part of doctors, police or prosecutors, nor did it fund efforts to study the impact. Neither did the law provide for expanding the programs needed to keep these mothers in treatment and out of jail.