Abusive Pregnancy

September 12, 2014 permalink

Fixcas has had many stories of parents who got in trouble with child protectors for failing to follow doctor's orders. A mother known only as YN is in trouble because she DID follow doctor's orders. She took prescription methadone during pregnancy. The state of New Jersey put her on its register of child abusers for harming her child during pregnancy.

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New Jersey mother fights for removal from abuse registry over prescribed methadone use during pregnancy

Woman in appeals after being found culpable of abuse and neglect of unborn baby despite being supervised by doctor

A mother in New Jersey is fighting to have her name removed from the child abuse register after she was found culpable of abuse and neglect of her unborn baby because she took methadone during pregnancy, even though the treatment was prescribed and supervised by a doctor.

The woman, identified only as YN in court documents, has protested the abuse finding to the New Jersey supreme court, the highest judicial panel in the state. On Monday the court’s six justices considered the legal arguments behind her censure.

YN’s case is being seen as the latest battleground in the growing trend towards penalizing women for the outcomes of their pregnancies. At most extreme, women in states such as Indiana and Mississippi have been charged with fetal murder after they lost their babies.

YN has not been criminally charged, and her case has been heard under the civil court system. But her presence on the child abuse register still has potentially devastating consequences, as it could prevent her finding a job and make it more difficult for her to care for her son.

After a full-term pregnancy, YN gave birth to a vigorous boy on 18 February 2011. But soon afterwards the baby, referred to as PAC, began displaying symptoms of methadone withdrawal and was diagnosed as having neonatal abstinence syndrome.

YN was struggling with addiction of opioid painkillers at the time she learned that she was pregnant, and was advised by a physician to undergo opioid substitution therapy by which she would switch to a closely-regulated dose of methadone. Such a course, known as methadone maintenance treatment or MMT has been described as the “gold standard” for pregnant women wrestling with painkiller addiction – an epidemic problem in the US.

Doctors have been advising pregnant women with addiction problems to use methadone since the early 1970s, as it is widely recognized to be less dangerous for the foetus than stopping all opioid consumption which can lead to “cold turkey” for the mother and severe withdrawal or even miscarriage for the unborn child. The World Health Organisation has called it “the most appropriate treatment”; the US federal government says MMT “is safe for the baby”; and even New Jersey’s own department of human services advocates methadone maintenance in such circumstances.

YN followed her doctor’s treatment plan for methadone for the final six weeks of her pregnancy. It is not unusual for babies to suffer withdrawal symptoms from the drug after birth, though PAC endured particularly severe neonatal abstinence syndrome and had to be given oral doses of morphine from which he was gradually weaned over a period of 39 days.

The mother was reported to New Jersey’s child protection agency which found she had committed abuse and neglect. In June last year, the state’s appeal court upheld the finding, ruling that the harm PAC suffered from withdrawal was enough in itself to justify putting YN on the child abuse register.

“The fact that [YN] obtained the methadone from a legal source does not preclude our consideration of the harm it caused to the newborn. Where there is evidence of actual impairment, it is immaterial whether the drugs taken were from a legal or illicit source,” the appeal court judges ruled.

A coalition of 76 groups and experts in child health, maternal and fetal rights and addiction treatment, including the American College of Obstetricians and Gynecologists, have joined to protest the appeal court ruling and YN’s censure for abuse and neglect. In a brief to the supreme court justices, the parties argue that the finding of abuse and neglect was “based upon myths, stereotypes and prejudices” and had failed to take on board “evidence-based research or scientific evidence” on the benefits of methadone treatment under proper medical supervision.

At the hearing on Monday, the supreme court justices restricted themselves to one specific legal question: could a pregnant woman be found culpable of abuse and neglect on the basis that the methadone she used under a drug treatment programme caused harm to the newborn child.

Clara Licata, a lawyer representing YN, told the court that her client had been advised “that she should not withdraw [from painkillers] abruptly on her own and the only reasonable course of action was to take methadone in a medical setting.”

Licata added: “There is a risk in second-guessing a woman’s decision during pregnancy. The fear is that people will look back over the pregnancy and question the mother’s reasonableness: did she sleep too much or too little? Did she exercise too much or too little?”

In its argument to the supreme court, the state of New Jersey argued that YN had a six-year history of drug use and had taken illegal street drugs for most of her pregnancy. It said it was right that YN was kept on the abuse register, given all the factors in the case, to safeguard her child.

Sara Ainsworth of the National Advocates for Pregnant Women told the Guardian that it was inappropriate for child protection agencies to intervene in cases where pregnant women with addiction problems had sought medical treatment. “If we are going to start policing pregnant women for their babies’ condition at birth then we are entering a very dangerous world – not only her medical decisions but all her decisions are subject to being labeled neglect or abuse.”

Source: Guardian (UK)