title: Prenatal Substance Use: Exploring Assumptions of Maternal Unfitness.
abstract: In spite of the growing knowledge and understanding of addiction as a chronic relapsing medical condition, individuals with substance use disorders (SUD) continue to experience stigmatization. Pregnant women who use substances suffer additional stigma as their use has the potential to cause fetal harm, calling into question their maternal fitness and often leading to punitive responses. Punishing pregnant women denies the integral interconnectedness of the maternal-fetal dyad. Linking substance use with maternal unfitness is not supported by the balance of the scientific evidence regarding the actual harms associated with substance use during pregnancy. Such linkage adversely impacts maternal, child, and family health by deterring pregnant women from seeking both obstetrical care and SUD treatment. Pregnant women who use substances deserve compassion and care, not pariah-status and punishment.
authors.affiliation: Behavioral Health System Baltimore, Baltimore, Maryland, USA. ; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Mishka
authors.initials: M
authors.lastname: Terplan
authors.affiliation: Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Alene
authors.initials: A
authors.lastname: Kennedy-Hendricks
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Chisolm
keywords: fetal exposure; neonatal abstinence syndrome; opioid use in pregnancy; pregnancy; pregnant women; public attitudes; public policy; substance use in pregnancy