Senator Blumenthal held a roundtable discussion with 15 medical professionals at the Yale School of Medicine recently to address the opioid epidemic in Conn. They shared anecdotes, suggestions and opinions about curbing the use of and misuse of drugs. In the opening paragraphs of the Register Citizen news report was the story that gave insight into the stigma that the medical field places on babies born to mothers that use drugs.
Wolfson treated the child as part of a physical diagnosis course. Now a cardiologist at Yale New Haven Hospital and chairman at the Connecticut State Medical Society Council, Wolfson said he recalls his teacher's response after he told him that he couldn't find anything wrong with the baby.
"He says, 'You're right, there is nothing wrong with him; he's a junkie,'" Wolfson said.
Junkie, addicted baby, oxytot is the language used by many medical professionals while caring for these babies. From the day that these babies are born, a stigmatizing label has been placed upon them. The media then uses such language to shock and reinforce the myth that babies are born addicted. They are not; they have Neonatal Abstinence Syndrome, (NAS) which is treatable.
Not only is this language an assault on pregnant women, referring to their babies as junkies continues the stigma and the underlying contempt into the next generation. Doctors know that NAS is treatable and that babies are not born addicted yet they do not speak up to correct the myth. These doctors know better; but they remain silent as the public outcry demands that pregnant women be forced into treatment, have their babies removed and reported to child protective services, charged with child abuse, arrested and imprisoned. When medical professionals allow themselves to refer to these babies in stigmatizing language, they perpetuate discrimination against pregnant women and the care of their infants to continue.
Advocates for prevention, treatment and recovery from substance use disorder are at a loss as to how to advocate for pregnant women that may have used during their pregnancy or who have substance use disorder. Pregnant women are left without support, little treatment options and an awkward silence of shame. Frightened, they fail to seek prenatal care, fail to confide in their doctors and may deliver without needed medical support. The American College of Obstetricians and Gynecologist Committee Opinion reaffirmed in 2014 that drug enforcement policies deter women from seeking prenatal care and are contrary to the welfare of the mother and fetus. The opinion further states that obstetricians are encouraged to work to retract legislation that punishes women for substance abuse during pregnancy. Furthermore, other leading medical and public health groups -- such as the American Academy of Pediatrics, the American Medical Association, the American Public Health Association and the March of Dimes -- all oppose punitive responses to prenatal drug use. Contrary to these respected medical recommendations, legislators continue to pass laws to punish pregnant women or use legislation to force them into treatment; treatment that goes unfunded, does not provide for the complex issues of treating pregnant women, are extremely limited within states or simply does not exist.
Fueled by media depictions of babies receiving neonatal aftercare, men and women alike view these infant pictures as distasteful and agree that mothers be held accountable when babies are born with symptoms of NAS. Unlike babies with fetal alcohol syndrome, which may leave permanent disabilities, babies with NAS do not show long-term effects and thrive normally. The public does not seem to understand that "Oxytots" grow to be beautiful children.
Advocates seeking forced treatment demand that women be held accountable for exposing their babies to substances while in the womb. Yet forced addiction treatment mandated through the criminal justice system and other forms of coercion is medically unsound and is viewed as unethical by both addiction specialists and the medical field. Legislators and governors are pushed by well meaning advocates wishing to expand treatment options without realizing that coercion is an unacceptable medical practice. Trying to prevent substance use and abuse in the youngest of children, legislation is written so that pregnant women as well as their doctors, nurses and hospitals are placed under strict guidelines and reporting requirements concerning pregnant women.
Hospitals have been forced to set policies of testing for drugs during pregnancy and birth and report these findings to police, many times without the mother's knowledge or consent. Babies are taken away from mothers, not allowed to nurse, may not be allowed to go home with the mother and may be placed in foster care. Mothers may lose housing benefits and medical benefits as well as other children in their care.
As the opioid and heroin crisis has expanded across the United States so too have laws specifically written against pregnant women that use drugs. These laws may have the best of intentions but are now being used to detain, force care and harshly punish. Instead of a welcomed birth event to be celebrated, the family is left distraught, shamed and traumatized. The doctor needs to report; a junkie was born.
Propublica investigative report titled, When the Womb is a Crime Scene expertly reported on how laws are being used to criminally charge and prosecute pregnant women. Although laws vary across the county, legislation in South Carolina, Tennessee and Wisconsin are particularly harsh. Laws originally intended to protect mothers from assault of their unborn child are now being used to criminally prosecute pregnant women themselves. These are not isolated instances; pregnant women have a reason to fear.
It is in the best interest of society for pregnant women to receive the prenatal healthcare that they deserve without stigmatizing language from medical professionals and the interference of law enforcement. For the sake of the child and the family, a new tone must be set during prenatal care and in the delivery room. A baby is born, not junkie, not addicted baby or oxytot; a beautiful baby.
Compassionate health care without fear-based legislation is what is needed to help families. Pregnant women need to be encouraged to seek prenatal care and substance treatment that is of benefit to the mother and child. They need privacy to honestly speak with their doctors about their medical needs without judgment or shame. More medical professionals need to advocate and protect the needs of the patient as they guide them through their pregnancies and birth. Supportive community services such as visiting nurses, parenting support, baby and mother wellness checks, nutritional counseling, educational services and childcare need to be affordable and easy to access. Respect, compassion, support and acceptance should be the standard of care and legislation should reflect that; our society depends on it.
This video gives further explanation into the unintended consequences of laws against pregnant women.
Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.