Do state policies intended to reduce and eliminate alcohol use among pregnant women work? And, do the effects vary by pregnant women’s educational status?
Research by a team with scientists from the Prevention Research Center at the Pacific Institute for Research and Evaluation finds that the answer to the first question is that, overall, such policies are associated with increases in low birth weight and pre-term births as well as decreases in prenatal care use.
Further, the effects of alcohol use during pregnancies policies vary based on the educational status of pregnant women. In general, women with more education experience health harms, and women with less education avoided harms or sometimes experienced health benefits.
The policies include:
- Mandatory warning signs posted where alcoholic beverages are sold as well as healthcare facilities.
- Priority treatment for pregnant women and women with children makes access to substance abuse treatment for pregnant and postpartum women a priority.
- Reporting requirements for data and treatment purposes: reporting of alcohol use or abuse by pregnant women to either Child Protective Services or a health authority.
- Prohibitions on criminal prosecution prohibits use of the results of medical tests, such as prenatal toxicology tests, as evidence in the criminal prosecutions of women who may have caused harm to a fetus or a child.
- Civil commitment: involuntary commitment of a pregnant woman to treatment or protective custody for the protection of a fetus from exposure to alcohol.
- Reporting requirements for child protective services purposes, and child abuse/child neglect: the legal significance of a woman’s conduct prior to birth of a child and of damage caused in utero and, in some cases, define alcohol use during pregnancy as child abuse or neglect.
The implications of this research are that new policy approaches that reduce harms from alcohol use during pregnancy for all pregnant women are needed.
Source: Roberts, S. C. M., A. A. Mericle, M. S. Subbaraman, S. Thomas, W. Kerr, and N. F. Berglas. “Variations by Education Status in Relationships Between Alcohol/Pregnancy Policies and Birth Outcomes and Prenatal Care Utilization: A Legal Epidemiology Study.” Journal of public health management and practice: JPHMP 26 (2020): S71.