NCJ Number
200946
Date Published
2003
Length
5 pages
Annotation
Following an overview of the epidemiology/statistics of prenatal drug and alcohol abuse by expectant mothers, this chapter discusses policy and legislation relevant to the impact of prenatal drug exposure on the developing infant and child and its relationship to child abuse and neglect, followed by recommendations.
Abstract
The prevalence of prenatal drug use is estimated to be as high as 10-20 percent, although the prevalence probably varies with ethnicity, socioeconomic status, and geographic location. Medical intervention, such as early prenatal care, is an effective strategy in prenatal care delivery for women who use alcohol and abuse substances. All illicit drugs reach the fetal circulation by crossing the placenta and can cause direct toxic effects on the fetus, as well as fetal and maternal dependency. In the newborn period, the most consistent findings of multiple studies that have investigated the outcomes of drug exposed infants included increased rates of prematurity, lower birth weights, and smaller head circumferences. Perinatal cerebral infarctions have occurred in infants whose mothers have used cocaine a few days before delivery. This chapter thus advises that substance abuse by pregnant and parenting women is a disease that may lead to child abuse and neglect. The threat of criminal prosecution for mothers who use drugs prenatally has been a deterrent to expectant mothers seeking medical care and drug treatment services. California passed Senate Bill 2669 in 1990; it states that a positive toxicology screen at the time of delivery of an infant is not, in and of itself, a sufficient basis for reporting child abuse or neglect. The protocol for implementing the law provides guidance in identifying needed services designed to assist the mother in caring for her child and offers a framework for determining the level of risk to the newborn if released to the home. The services and intervention needed to protect the infant's health and safety are determined. Comprehensive, culturally and linguistically appropriate rehabilitation treatment centers for women and their children are needed to address the multiple issues that face drug-abusing, parenting women. Medical intervention, such as early prenatal care, rehabilitation services for pregnant women, and comprehensive pediatric care for the infant and child, planned and funded in a comprehensive manner can help pregnant and parenting women with chemical dependency cope with their addiction, support the health of the fetus/newborn, promote good infant and child outcome, and prevent child abuse and neglect. A relevant case vignette with follow-up questions is presented. 37 references