Tennessee has become the first state in the nation to pass a law criminalizing women for their pregnancy outcomes. Republican Gov. Bill Haslam took the 10 days allotted to him to consider the advice of doctors, addiction experts and reproductive health groups urging him to veto the punitive and dangerous measure that allows prosecutors to charge a woman with criminal assault if she uses illegal drugs during her pregnancy and her fetus or newborn is considered harmed as a result. Haslam ignored these recommendations — and the recommendations of nearly every major medical association, including the White House Office of National Drug Control Policy — and signed the measure anyway.
Opponents of the new law share a concern that a lack of access to health care and treatment facilities will result in the disproportionate targeting and jailing of poor mothers and mothers of color, particularly in rural districts throughout the state.
Republican state Sen. Mike Bell, one of the seven Republicans in the state Senate to vote against the measure (every Democrat in the state Senate voted in favor), recently told Salon that this lack of access is a problem he thinks will hurt the women of his district and their families. “I represent a rural district,” he said. “There’s no treatment facility for these women there, and it would be a substantial drive for a woman caught in one of these situations to go to an approved treatment facility. Looking at the map of the state, there are several areas where this is going to be a problem.”
Only two of the state’s 177 addiction treatment facilities that provide on-site prenatal care allow older children to stay with their mothers while they are undergoing treatment. And only 19 of these facilities offer any addiction care specifically oriented toward pregnant women. Tennessee has also refused the Medicaid expansion, leaving many women without reliable access to basic medical or prenatal care, much less drug treatment.
The law does nothing to expand treatment options for women in Tennessee, a fact that did not seem to trouble Republican state Rep. Terri Lynn Weaver, who sponsored the House version of the bill and remains one of its most vocal defenders. “I don’t know what to say about [how] some [women] have insurance and some do not,” she recently told Salon. “It’s a terrible thing, but I don’t want to get into that because that’s another subject.”
Women who seek treatment after arrest may be able to avoid jail time, but drug treatment providers have expressed concerns that the language of the law as it was passed does not allow women to seek methadone or buprenorphine maintenance — recommended treatment for pregnant women addicted to narcotics — as part of their defense. Pregnant women with substance dependence to narcotics are recommended to undergo maintenance treatments — rather than detoxification — since withdrawal carries pregnancy risks.
The American Medical Association, American Academy of Pediatrics, American College of Obstetricians and Gynecologists and other major medical associations — joined by local doctors and addiction specialists — have warned that measures criminalizing pregnant women will only discourage them from seeking prenatal care and drug treatment. These concerns were made expressly clear to the governor by groups like SisterReach, a Tennessee-based reproductive justice group and Healthy & Free Tennessee, a state-wide reproductive health coalition.
“Despite our advocacy attempts and regardless of the impact this law will have on marginalized families; despite the danger that medical professionals have noted a law of this magnitude will cause, our governor chose his party over the experts,” SisterReach founder and CEO Cherisse A. Scott said in a statement. ”This law separates mothers from their children and is not patient-centered. Tennessee families who are already being hit the hardest by policies such as the failure to expand Medicaid, poverty and a lack of available drug treatment facilities will be most deeply impacted by this bill. Mothers struggling with drug addiction in Shelby County, rural communities throughout Tennessee and poor mothers and their families will be the ones who suffer the effects of this dangerous legislation the most.”
“We are very sorry to see that Governor Haslam let an opportunity to do the right thing slip through his fingers,” Rebecca Terrell, Chair of Healthy & Free Tennessee, said in a statement. “The experts could not have been clearer: this law is bad for babies and bad for Tennessee.”