April 11, 2018
Pennsylvania child advocates are closely watching an upcoming state Supreme Court case that will decide whether a woman’s use of narcotics while pregnant is considered child abuse, in a state where at least five babies a day are born dependent on prescription and illegal drugs, according to new state data.
“I can see there is a concern, but I will tell you this, from my perspective, this would be absolutely disastrous,” said Angela Liddle, CEO and president of the Pennsylvania Family Support Alliance in Harrisburg. “I cannot see anyone who works in the child welfare area saying that this is a good thing, and in the long run that it will better protect the child.”
The state’s highest court last week agreed to hear a case involving a Clinton County mother, identified in court records as “A.R.,” who gave birth in January 2017 to a child — identified in court records as “L.B.” — who subsequently was diagnosed with neonatal abstinence syndrome, a collection of symptoms frequently associated with opiate and opioid withdrawal that include fever, seizures and tremors, vomiting, inconsolably crying, feeding and sleep difficulty.
The mother later tested positive for marijuana, benzodiazepines and suboxone, the latter a drug commonly prescribed pregnant women with opiate use disorders, but she did not have a prescription for the drugs, which made the use illegal, according to court records in the case.
The hospital reported the newborn to local child welfare authorities, as required under a 2003 federal law that requires child protection workers assess the family home environment and create a plan of safe care for newborns who show signs of narcotics withdrawal. County child welfare filed for emergency protective custody of the infant and in its petition the agency alleged the newborn was a “victim of child abuse,” noting the newborn had been hospitalized for 19 days for treatment.
Commonwealth court agreed to put the child in state custody, but decided that the mother’s actions were not considered child abuse under the civil Child Protective Services Law since the law does not apply to a fetus.
In December, though, the state Superior Court reversed the lower court, stating while a fetus does not meet the definition of a “child” under the state law, after the infant was born — diagnosed and treated for NAS — the abuse definition was met. The appeals court decision cleared the way for a child abuse finding to be filed against “A.R.,” which could restrict her ability to interact with children in the future.
Local child advocates condemned the idea of including prenatal drug use in the definition of child abuse. They cited the near universal recognition among medical and public health organizations that substance abuse is a chronic medical condition and abruptly stopping opioid or opiate use during pregnancy places a mother and fetus is potentially life-threatening to both.
“If substance abuse during pregnancy is defined as child abuse, women may be less likely to seek treatment during pregnancy or to discuss their drug use with health care providers,” said Daniel Miringoff, Chief Community Program Officer at the Family Service Association of Bucks County, one of Pennsylvania’s Center of Excellence for opiate use disorder care. “This could lead to negative consequences for both mother and baby. We want pregnant women to open up about addiction, and that is best done when we recognize and treat addiction as the illness it is.”
Advocates added that the case touches on constitutional issues that could have broad implications for pregnant and child-bearing age women and it could open a door to other prenatal actions being considered as child abuse including smoking, eating raw fish, staying with an abusive partner and traveling to countries with health advisories such as during the 2015-16 Zika outbreak.
In Pennsylvania, parental substance abuse does not meet the definition of child abuse, meaning a parent cannot be found to have committed abuse or neglect against a child based only on drug use.
Fourteen other states and the District of Columbia include prenatal narcotics exposure in their state definitions of child abuse or neglect, as of 2015, the most recent year statistics were available through the Child Welfare Information Gateway, a federal information service.
Cathleen Palm, the founder and executive director of the Center for Children’s Justice in Berks County, noted that Congress has consistently reinforced that its 2003 mandate that local child welfare authorities develop a plan of safe care for infants with prenatal drug exposure is not a punitive measure, but a protective one.
Palm was among the advocates who wondered if the high court found prenatal narcotics exposure meets the state’s child abuse definition, how it would impact women properly taking prescribed opiate replacement drugs, known as Medication Assisted Treatment. MAT is a commonly prescribed therapy for pregnant heroin abusers as part of drug treatment, but it carries the same risk of developing NAS in newborn as taking illegal opiates.
“That seems to become a pretty slippery slope,” Palm added.
No comments:
Post a Comment