Criminalizing Prenatal Drug Use May Discourage Pregnant Individuals from Seeking Medical Care

States that explicitly criminalize prenatal drug use may unintentionally discourage pregnant people from seeking essential medical care, according to new research from Columbia University Mailman School of Public Health. The study is the first to empirically test whether fear of legal repercussions leads some people with drug-use disorders to give birth outside health care settings to avoid hospital drug testing. The findings arepublishedinSocial Science & Medicine. "Comprehensive perinatal care is crucial for healthy pregnancy outcomes, yet people who use drugs are significantly less likely to receive it," said Emilie Bruzelius, a postdoctoral fellow in Epidemiology at Columbia Mailman School, and first author. "Our findings suggest that criminalizing prenataldruguse may worsen this gap by driving avoidance of health care services." The researchers examined more than 124 million births across 83,300 county-years and found that explicit prenatal drug criminalization policies were associated with reductions inprenatal careand facility-based deliveries. For example, states adopting such policies saw declines in overall and first-trimester care initiation. In particular, there were on average 4,396 fewer births per 100,000 with any prenatal care in criminalization states relative to non-criminalization states. Additionally, criminalization was associated with 1,848 fewer facility-based deliveries.