Everyday Struggles, Everyday Strengths: report from Young Women United

Capturing the voices of women living though pregnancy and addiction


I blogged earlier this year about an organization in New Mexico called Young Women United (see the post: Young Women United: Campaign to Increase Access to Care and Treatment for Pregnant Women with Addictions, February 18, 2014).

The organization has released a new report called “Everyday Struggles, Everyday Strengths: Capturing the voices of women living though pregnancy and addiction.

Some of the key findings from their work with women include:

1. Most women described intense feelings of fear as guiding their decisions.

  • They were fearful their kids would not be healthy and that they would be at fault.
  • They were scared of being reported to child welfare authorities and losing custody of their baby as well as other children.
  • While some women disclosed their substance use and others hid their substance use, almost all women were scared to talk about their substance use due to risk to their families.

2. The majority of women reported judgement and discrimination while trying to access prenatal care.

  • Some women reported that their health care providers allowed their own opinions on addiction to impact the care they provided, regardless of whether those decisions were sound or legal.
  • Many women said they were not treated respectfully or kindly.
  • Several women reported being threatened with inaccurate information (e.g., “You know they’re going to take those kids away from you?”)

3. Women reported not being able to access the care and support they needed.

  • It was difficult to access prenatal care that incorporated addiction treatment or addiction treatment that considered pregnancy.
  • For many families, treatment was only affordable when facing criminal charges.
  • For women who are mothers, residential treatment was usually inaccessible because they could not take their children with them and/or they did not have a safe place for their children to stay in their absence.

This report seems especially timely given the announcement a couple of weeks ago when the governor of Tennessee announced a new law to authorize the arrest and incarceration of women who use drugs while pregnant. (See the coverage in the Huffington Post here and the Washington Post coverage here).

While the Tennessee bill is the first state to actually criminalize drug use among pregnant women, other states have been prosecuting pregnant women under different kinds of laws for years. The criminalization and prosecution of pregnant women who use alcohol and drugs has been critiqued by hundreds of health and other organizations as poor public policy and has not been shown to lead to positive outcomes.

For more on this issue, see earlier posts:


European FASD Alliance Position Paper: Mothers who drank during pregnancy should not be punished


Screeshot - Telegraph_Feb 2 2014

Over the past couple of months, there has been media attention about a new legal test case going before the Court of Appeals in the United Kingdom. This case has raised concerns and discussion in Europe (and elsewhere) about punishing women who drink alcohol during pregnancy.

The case in the UK is arguing that a six-year-old girl who suffered brain damage due to alcohol exposure in the womb is the victim of a crime (grievous bodily harm). While this claim was initially overturned in December 2011, an appeal is going forward. If successful, women who drank during pregnancy could be convicted of a criminal act. Interesting, this is occurring even while current UK national guidelines on alcohol use during pregnancy state: “Expectant mothers should avoid alcohol – but if they do choose to drink, they should limit their consumption to one or two units a week.”

The European FASD Alliance released a position statement last week called “Drinking during pregnancy-who is responsible?

“The EUFASD Alliance does not agree that mothers who drank during pregnancy should be punished. We recognize that there are many reasons that women drink, for example not knowing that they are pregnant, or due to bad advice from their health care advisors or the press. We recognize that social pressures play a great role in encouraging women to drink.”

The position statement has been cosigned by a number of other organizations. See the position paper here on the European FASD Alliance website.

For more on punishing or criminalizing alcohol use during pregnancy, see early posts:

State Policies on Substance Abuse During Pregnancy


The Guttmacher Institute in the United States works to advance sexual and reproductive health and rights through research, policy analysis and public education.

The two-page Substance Abuse During Pregnancy is part of their “State Policies in Brief” series and tackles the subject of how women’s substance abuse during pregnancy is dealt with at a policy level. While no state specifically criminalizes drug use during pregnancy, many prosecutors use other criminal laws to address prenatal substance use.

“Several states have expanded their civil child-welfare requirements to include prenatal substance abuse, so that prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect. Further, some states, under the rubric of protecting the fetus, authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant women who use drugs; these policies sometimes also apply to alcohol use or other behaviors.

A number of states require health care professionals to report or test for prenatal drug exposure, which can be used as evidence in child-welfare proceedings. And in order to receive federal child abuse prevention funds, states must require health care providers to notify child protective services when the provider cares for an infant affected by illegal substance abuse. Finally, a number of states have placed a priority on making drug treatment more readily available to pregnant women, which is bolstered by federal funds that require pregnant women receive priority access to programs.”

The summary includes a checklist of which states consider substance abuse during pregnancy as child abuse or grounds for civil commitment, which states require reporting or testing when substance misuse is suspected, and which states have specific programs for pregnant women who use substances and give pregnant women priority access to general programs.

For more on the criminalization of prenatal substance use and legal issues related to FASD prevention, see earlier posts: