{"id":7297,"date":"2014-05-09T13:52:28","date_gmt":"2014-05-09T18:52:28","guid":{"rendered":"http:\/\/thesocietypages.org\/girlwpen\/?p=7297"},"modified":"2014-05-09T13:52:28","modified_gmt":"2014-05-09T18:52:28","slug":"criminalizing-good-maternal-health-care-in-tennessee","status":"publish","type":"post","link":"https:\/\/thesocietypages.org\/girlwpen\/2014\/05\/09\/criminalizing-good-maternal-health-care-in-tennessee\/","title":{"rendered":"Criminalizing Good Maternal Health Care in Tennessee"},"content":{"rendered":"<p>In honor of Mother\u2019s Day, I ask readers to consider the ramifications of a new law about pregnant women which has dangerous implications for the health of mothers and babies. The author of this guest post,\u00a0<a href=\"https:\/\/twitter.com\/CarmonaChelsea\" target=\"_blank\">Chelsea Carmona<\/a>, is a writer and drug treatment activist whose writing has been featured in major media outlets like <i>Time<\/i>, <i>The Washington Post<\/i>, <i>The Guardian<\/i>, and <i>Al Jazeera English<\/i>. She works for <a href=\"http:\/\/www.theopedproject.org\/\" target=\"_blank\">The OpEd Project<\/a>, a social venture founded to increase the range and quality of voices we hear in the world.<\/p>\n<p>__________<\/p>\n<p><span style=\"font-size: 13px\"><a href=\"https:\/\/www.flickr.com\/photos\/bies\/107729240\/in\/set-72057594106354051\/\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-7299 alignleft\" alt=\"107729240_3278d325a5_m\" src=\"https:\/\/thesocietypages.org\/girlwpen\/files\/2014\/05\/107729240_3278d325a5_m.jpg\" width=\"240\" height=\"160\" \/><\/a>Can you imagine being prosecuted and potentially incarcerated for taking an FDA-approved, legally prescribed medication \u2013 a medication both the <\/span><a href=\"http:\/\/www.who.int\/bulletin\/volumes\/86\/3\/08-010308\/en\/\" target=\"_blank\">World Health Organization<\/a><span style=\"font-size: 13px\"> and the <\/span><a href=\"http:\/\/www.nap.edu\/openbook.php?record_id=4899&amp;page=1\" target=\"_blank\">Institute of Medicine<\/a><span style=\"font-size: 13px\"> agree is the most effective treatment for your affliction?<\/span><\/p>\n<p><span style=\"font-size: 13px\">Starting July 1<\/span><sup>st<\/sup><span style=\"font-size: 13px\">, this is a real possibility for pregnant women in Tennessee undergoing methadone maintenance, an evidence-based pharmaceutical therapy known among experts as the \u201cgold standard\u201d of treatment for opioid addiction.<\/span><\/p>\n<p><span style=\"font-size: 13px\">The <\/span><a href=\"http:\/\/www.capitol.tn.gov\/Bills\/108\/Amend\/SA0858.pdf\" target=\"_blank\">bill<\/a><span style=\"font-size: 13px\">, signed into law on Tuesday &#8212; despite avid opposition from addiction experts, reproductive health advocates, and virtually every <\/span><a href=\"http:\/\/advocatesforpregnantwomen.org\/medical_group_opinions_2011\/Medical%20Group%20Positions%202011.pdf\" target=\"_blank\">major medical association<\/a><span style=\"font-size: 13px\"> &#8212; authorizes the arrest and incarceration of women who use illegal drugs while pregnant.<\/span><\/p>\n<p><span style=\"font-size: 13px\">The law does nothing to expand treatment options for addicted women, but proponents maintain the intention is to help pregnant women struggling with substance abuse get into programs. Considering <\/span><a href=\"http:\/\/action.rhrealitycheck.org\/page\/s\/gov-haslam-veto-pregnancy-criminalization-sb-1391\" target=\"_blank\">only 19 of Tennessee\u2019s 177 addiction treatment facilities<\/a><span style=\"font-size: 13px\"> provide any form of care to pregnant women, this is going to be a challenge.<\/span><\/p>\n<p><span style=\"font-size: 13px\">Targeted women can avoid criminal charges if they complete state-approved treatment, but the Tennessee penal code doesn\u2019t specify what constitutes an \u201caddiction recovery program.\u201d In 2007, the 9<\/span><sup>th<\/sup><span style=\"font-size: 13px\"> Circuit Court ruled that forced attendance in 12-step programming (Alcoholics Anonymous) is unconstitutional, but this model still reigns supreme in treatment today, leaving methadone maintenance highly suspect.<\/span><\/p>\n<p><span style=\"font-size: 13px\">Advocates for pregnant women share concerns that the widespread ignorance of maintenance treatment could leave pregnant women on methadone vulnerable to prosecution, even though such treatment is widely considered <\/span><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK64148\/\" target=\"_blank\">the standard of care<\/a><span style=\"font-size: 13px\"> for opioid-dependent, pregnant women. The language of the new law does not specifically exempt these women from prosecution, making following doctors\u2019 orders a potential crime.<\/span><\/p>\n<p><span style=\"font-size: 13px\">Sadly, this can\u2019t be surprising to anyone familiar with maintenance treatment. Although advances in science have helped us to establish a more comprehensive understanding of the disease, we have a deeply entrenched narrative of drug addiction in our culture. This new law, which will only scare women away from seeking the prenatal and addiction care they so desperately need, is the result of this misguided and moralistic view.<\/span><\/p>\n<p><span style=\"font-size: 13px\">Opponents of the law also worry that it will result in disproportionate jailing of poor pregnant women and pregnant women of color, particularly those living in rural districts where there is significantly less access to treatment. And they are right to be concerned.<\/span><\/p>\n<p><span style=\"font-size: 13px\">According to <\/span><a href=\"http:\/\/www.amazon.com\/Influence-National-Addiction-Substance-University\/dp\/B008SLELTY\" target=\"_blank\">The National Center on Addiction and Substance Abuse at Columbia University<\/a><span style=\"font-size: 13px\">, even though women fare just as well in treatment as men, 92% of those in need do not receive it. This is in large part due to practical reasons: Women are more likely to live under the poverty line and therefore less likely to be able to afford costly inpatient programs and the childcare services that may be necessary for them to attend.<\/span><\/p>\n<p><span style=\"font-size: 13px\">Women were actually mobilizing to advocate for feminist-based solutions to the problem of addiction as early as the late 1960s, but locating and gaining access to effective treatment is still infuriatingly difficult. Few treatment programs have separate women-only programs, and even fewer offer programs for pregnant or post-partum women.<\/span><\/p>\n<p><span style=\"font-size: 13px\">With the <\/span><a href=\"http:\/\/www.alternet.org\/addictions-shrinking-gender-gap\">shrinking gender gap in addiction<\/a><span style=\"font-size: 13px\">, it\u2019s time we take into account the gendered experiences that occur throughout addiction and cultivate a more compassionate, comprehensive perspective, one that is actually conducive to helping women achieve sobriety.<\/span><\/p>\n<p><span style=\"font-size: 13px\">For example, detailed, individual aftercare is a critical service for all addicts, but it is particularly important for women in using relationships. Women are often introduced to drugs and drug using rituals by a significant other, and rather than causing conflict, the use becomes a way to strengthen the bond. Although treatment stresses the importance of social networks, the loss of a using companion is always difficult &#8212; sometimes much more difficult than the loss of the addictive substance itself. By providing feminist-based aftercare &#8212; like housing-assistance, vocational counseling, and community development programs &#8212; recovering female addicts are much more likely to sustain sobriety and achieve autonomy.<\/span><\/p>\n<p><span style=\"font-size: 13px\">No one supports the use of illegal drugs among pregnant women, nor does anyone wish to see a newborn show signs of <\/span><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmedhealth\/PMH0004566\/\" target=\"_blank\">neonatal abstinence syndrome<\/a><span style=\"font-size: 13px\">, but incarceration isn\u2019t the answer. Instead, politicians should be forming natural alliances with feminist scholars and health advocates so we can collectively address the basic needs of newly sober women. These are the ways to truly celebrate Mother\u2019s Day.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In honor of Mother\u2019s Day, I ask readers to consider the ramifications of a new law about pregnant women which has dangerous implications for the health of mothers and babies. The author of this guest post,\u00a0Chelsea Carmona, is a writer and drug treatment activist whose writing has been featured in major media outlets like Time, [&hellip;]<\/p>\n","protected":false},"author":1918,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21094],"tags":[2257,124,2648,449,21560,3077,3109,27696,17580],"class_list":["post-7297","post","type-post","status-publish","format-standard","hentry","category-bedside-manners","tag-addiction","tag-crime","tag-drug","tag-justice","tag-maternal-health","tag-methadone","tag-motherhood","tag-prenatal-health","tag-substance-abuse"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/posts\/7297","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/users\/1918"}],"replies":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/comments?post=7297"}],"version-history":[{"count":6,"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/posts\/7297\/revisions"}],"predecessor-version":[{"id":7304,"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/posts\/7297\/revisions\/7304"}],"wp:attachment":[{"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/media?parent=7297"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/categories?post=7297"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thesocietypages.org\/girlwpen\/wp-json\/wp\/v2\/tags?post=7297"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}