How Pregnant Women with Substance Use Disorder Are Criminalized

By Kelly Burch 01/16/19

“The more we double down on the idea that pregnant women who struggle with addiction are terrible people and terrible mothers, the easier it becomes for... everyone else to treat them terribly."

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Mother and child will be better off. Cherayut Jankitrattanapokin |

Pregnant women in at least 45 states have faced criminal charges for abusing drugs while pregnant, stemming from the idea that they are doing harm to their unborn babies, according to a New York Times investigation.

Many addiction and recovery professionals, including Dr. Sarah Wakeman, who directs the substance use program at Massachusetts General, say that criminal charges result from and contribute to the stigma around addiction and the idea that substance use disorder is a moral failing or choice rather than a complex medical issue.

“The more we double down on the idea that pregnant women who struggle with addiction are terrible people and terrible mothers, the easier it becomes for doctors, social workers, judges and everyone else to treat them terribly,” Wakeman told the Times, which reported on the issue as part of a series about the rights of pregnant women. “When we criminalize women, we make them scapegoats for all of these large structural forces and societal failures that create poverty and give rise to addiction in the first place.”

At Massachusetts General, the Hope Clinic provides treatment and parenting support for pregnant women and mothers with substance use disorder. By helping women rather than criminalizing them, both mother and child fair better, Wakeman said.

In Tennessee, a law was passed two years ago that could force pregnant women with substance use disorder into jail, essentially claiming they need protective custody. However, the law backfired, resulting in women giving birth in risky situations or leaving the state, said University of Tennessee College of Law professor Wendy Bach. Now, the law is not being renewed.

“We started out saying we would curb drug use and promote treatment and care. We ended up deterring people from treatment while doing basically nothing to curb use,” she said.

Even when substance use doesn’t result in criminal charges, it can cause children to be taken from their families. Kasey Dischman, of Pennsylvania, got sober when she was pregnant with her first child. She maintained her recovery for years, until her daughter was eight and Dischman reconnected with the girl’s father.

Dischman said, “It was like we didn’t know how to be sober together.”

Dischman relapsed. She became pregnant again and accidentally overdosed, resulting in an emergency cesarean delivery for her second daughter.

She said that in the moment when she injected heroin, the pull of addiction was stronger than her concern for her daughters — something she believes shows the power of the illness.

“It’s almost like I forgot about them. I know that’s awful, and that people think I don’t have a conscience,” she said. “But that’s exactly what addiction is. Once it enters your head to do that shot, you develop this tunnel vision that nothing can break.”

Today, Dischman is sober but still facing a complex legal battle in hopes of regaining custody of her daughters, all while feeling like the system is set up against her.

“They don’t want me to recover from this,” she said. “Because if I do, if I make it through and I do all right, then what does that say about them, and about how they trashed me?”

Barry Lester, who specializes in opioid addiction as a professor of psychiatry and pediatrics at Brown University, said that the treatment of women like Dischman is short-sighted and hurtful.

“We love to hate these women,” he said. “But our hatred is not accomplishing anything.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.