Prenatal Substance Use Policies And Infant Maltreatment Reports.

We studied the effect of state punitive and supportive prenatal substance use policies on reports of infant maltreatment to child protection agencies. Punitive policies criminalize prenatal substance use or define it as child maltreatment, whereas supportive policies provide pregnant women with priority access to substance use disorder treatment programs. Using difference-in-differences methods, we found that total infant maltreatment reports increased by 19.0 percent after punitive policy adoption during the years of our study (2004-18). This growth was driven by a 38.4 percent increase in substantiated reports in which the mother was the alleged perpetrator. There were no changes in unsubstantiated reports after the adoption of punitive policies. We observed no changes in infant maltreatment reports after the adoption of supportive policies. Findings suggest that punitive policies lead to large increases in substantiated infant maltreatment reports, which in turn may lead to child welfare system involvement soon after childbirth in states with these policies. Policy makers should design interventions that emphasize support services and improve well-being for mothers and infants.

[1]  K. Simon,et al.  Marijuana liberalization policies and perinatal health. , 2021, Journal of health economics.

[2]  Danielle N Atkins,et al.  The Impact of State-Level Prenatal Substance Use Policies on Infant Foster Care Entry in the United States , 2021 .

[3]  Davida M. Schiff,et al.  A response to "Association between punitive policies and neonatal abstinence syndrome among Medicaid-insured infants in complex policy environments". , 2021, Addiction.

[4]  B. Stein,et al.  Association Between Punitive Policies and Neonatal Abstinence Syndrome Among Medicaid-Insured Infants in Complex Policy Environments. , 2021, Addiction.

[5]  P. Owens,et al.  Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010-2017. , 2021, JAMA.

[6]  D. Merritt.  How Do Families Experience and Interact with CPS? , 2020, The Annals of the American Academy of Political and Social Science.

[7]  Mir M. Ali,et al.  Association Between State-Level Criminal Justice-Focused Prenatal Substance Use Policies in the US and Substance Use-Related Foster Care Admissions and Family Reunification. , 2020, JAMA pediatrics.

[8]  C. Durrance,et al.  State Policies That Treat Prenatal Substance Use As Child Abuse Or Neglect Fail To Achieve Their Intended Goals. , 2020, Health affairs.

[9]  Pedro H. C. Sant'Anna,et al.  Difference-in-Differences with Multiple Time Periods , 2018, Journal of Econometrics.

[10]  Lucy C. Hodder,et al.  It's Time to Support, Rather Than Punish, Pregnant Women With Substance Use Disorder. , 2019, JAMA network open.

[11]  B. Stein,et al.  Association of Punitive and Reporting State Policies Related to Substance Use in Pregnancy With Rates of Neonatal Abstinence Syndrome , 2019, JAMA network open.

[12]  Mir M. Ali,et al.  Foster care admissions and state-level criminal justice-focused prenatal substance use policies , 2019, Children and Youth Services Review.

[13]  S. Luczak,et al.  Planning for safe care or widening the net?: A review and analysis of 51 states’ CAPTA policies addressing substance-exposed infants , 2019, Children and Youth Services Review.

[14]  K. Kozhimannil,et al.  Substance use disorder treatment admissions and state-level prenatal substance use policies: Evidence from a national treatment database. , 2019, Addictive behaviors.

[15]  Andrew Goodman-Bacon.  Difference-in-Differences with Variation in Treatment Timing , 2018, Journal of Econometrics.

[16]  Laurie A. Drabble,et al.  Drug Use During Pregnancy Policies in the United States From 1970 to 2016 , 2018 .

[17]  John J. Prindle,et al.  Prenatal substance exposure diagnosed at birth and infant involvement with child protective services. , 2018, Child abuse & neglect.

[18]  Becci A. Akin,et al.  Parental drug use and permanency for young children in foster care: A competing risks analysis of reunification, guardianship, and adoption , 2017 .

[19]  R. Stone.  Pregnant women and substance use: fear, stigma, and barriers to care , 2015, Health & Justice.

[20]  A. Nuru-Jeter,et al.  Women's perspectives on screening for alcohol and drug use in prenatal care. , 2010, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[21]  S. Friedman,et al.  Disposition and health outcomes among infants born to mothers with no prenatal care. , 2009, Child abuse & neglect.

[22]  Kathryn A. Lee,et al.  Extrinsic Barriers to Substance Abuse Treatment among Pregnant Drug Dependent Women , 2003 .

[23]  B. Leake,et al.  Two-year placement outcomes of children removed at birth from drug-using and non-drug using mothers in Los Angeles , 1997 .