Many policies targeting alcohol use during pregnancy don't work: study

Policies intended to discourage or criminalize drinking while pregnant have no effect on infant health, or in some cases can actually be harmful, a new JAMA Network Open study finds.

Why it matters: The study is the latest research supporting evidence that criminalizing alcohol and drug use during pregnancy is leading to worse outcomes among newborns, experts say.

• "Unfortunately, these pregnancy-specific alcohol policies — all of the ones we look at — none of them seem to do anything consistently good for babies," said study author Sarah Roberts, a professor at the University of California, San Francisco.

What they found: Researchers examined the effect of nine state-level anti-alcohol policies on infant injuries and health for 1.4 million birthing person-infant pairs.

• Warning signs about drinking during pregnancy (often found in bars or restaurants) and policies that require health care providers to report pregnant people using alcohol to child welfare agencies did not decrease birth defects in infants.
• Instead, these policies actually led to an increase in infant injuries. This is likely in part due to the fear of being reported to child welfare agencies by health care providers, which is likely a large barrier to accessing treatment for alcohol misuse, Roberts said.
• Other policies, like mandatory treatment referrals, had no impact or positive effect on infant injury or morbidities.
• "Singling out pregnant people for policies related to alcohol and drugs is not helping babies be healthier or safer, and in fact, it seems to be making it worse," Roberts said.

Zoom out: Similar state policies that require pregnant people in treatment for opioid use disorder be reported to Child Protective Services led to separating the new parent and child in some cases.

• States are also using child abuse and neglect laws to prosecute new mothers for using drugs during pregnancy (or even before pregnancy), even after they have given birth, per the Marshall Project.

The bottom line: Even as evidence suggests criminalizing substance or alcohol use during pregnancy is not working, more states have been implementing such policies since 2005, the JAMA study found.

• "We need to get the policies that are leading to harm out of the way," Roberts said.