Advocacy and Health Policy |

Leading Experts in Women’s Health Care, Pediatrics & Addiction Medicine: “Pregnant Women with Substance Use Disorders Need Health Care, Not Incarceration”

Washington, DC—The American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the American Society of Addiction Medicine (ASAM), March of Dimes and the National Organization on Fetal Alcohol Syndrome (NOFAS) released the following statement in response to the policy instituted by the Big Horn County Attorney’s Office in Montana to prosecute and incarcerate pregnant women for drug/alcohol use:


“The American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the American Society of Addiction Medicine (ASAM), March of Dimes and the National Organization on Fetal Alcohol Syndrome (NOFAS) oppose in the strongest possible terms Big Horn County Attorney Gerald Harris’ vow to prosecute and jail pregnant women with substance use disorders.

“As ob-gyns, pediatricians, addiction medicine specialists and public health organizations, we are deeply committed to evidence-based, compassionate care that improves the health and well-being of mothers and children. We applaud advocates and lawmakers who seek to prevent adverse birth outcomes related to substance use through legislation and policies that support, rather than prosecute, women, children and families.

“While the risks associated with drug and alcohol use during pregnancy deserve greater attention and public investment, addiction is a chronic brain disease that needs medical treatment, not criminalization based on medical misinformation and stigma. There is a strong consensus among medical and public health organizations that a punitive approach during pregnancy is ineffective and harmful to both mothers and children.

“Incarceration and the threat of incarceration do not reduce the incidence of alcohol or drug use and can deter pregnant women who need help from seeking prenatal care. This is also harmful to children; studies have shown that receiving prenatal care significantly reduces the negative effects of substance use during pregnancy, including low birth weight and premature birth.

“About 50 percent of pregnancies in the U.S. are unplanned, and such a “crackdown” could result in the prosecution of expectant mothers who used alcohol or drugs before they even knew they were pregnant. Furthermore, the call to citizens to monitor the behavior of pregnant women and report women who are seen drinking or using drugs is deeply disturbing and counterproductive. Average citizens do not have the medical training and expertise to correctly identify if a pregnant woman is using substances that are harming her fetus. If such reporting results in a pregnant woman’s incarceration or containment, this could disrupt her prenatal care, and possibly ongoing addiction treatment, and put her health and the health of her fetus at risk.

“Women do not forfeit their constitutional rights when they become pregnant. Courts have concluded that prosecuting women differently based on their pregnancy status and gender violates their right to equal protection of the laws under the Fourteenth Amendment of the Constitution.

“Effective action must be taken to ensure a healthy outcome for both mother and baby while offering safe, effective, affordable, non-punitive, family-centered medical treatment for substance use disorders.”

About ACOG
The American College of Obstetricians and Gynecologists (ACOG), is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care.

About AAP
The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds.

About ASAM
The American Society of Addiction Medicine (ASAM) is a professional society representing over 5,000 physicians and associated professionals dedicated to increasing access and improving the quality of addiction treatment; educating physicians, other medical professionals, and the public; supporting research and prevention; and promoting the appropriate role of physicians in the care of patients with addiction. For more information, visit

About March of Dimes
March of Dimes leads the fight for the health of all moms and babies. By lobbying for policies to protect them, working to radically improve the healthcare they receive, pioneering research to find solutions to the toughest problems and empowering families with the knowledge and tools to have healthier pregnancies, March of Dimes builds on an 80-year legacy of impact and innovation to support every mom and every baby. Visit our websites and For detailed national, state and local perinatal statistics, visit You can also find us on Facebook or follow us on Instagram and Twitter.

The National Organization on Fetal Alcohol Syndrome (NOFAS) is a public health advocacy organization that works to prevent prenatal exposure to alcohol, drugs, and other substances known to harm fetal development by raising awareness and supporting women before and during their pregnancy, and supports individuals, families, and communities living with Fetal Alcohol Spectrum Disorders (FASDs) and other preventable intellectual/developmental disabilities. For more information, visit