OPINION: Governor's order will cause mothers to avoid care

“I took three long weeks to make that first appointment. Each day was a brutal wrestling match. The meth still had its grip, whispering doubts, telling me I wasn’t worth the effort, that this ‘help’ would just be another trap, another disappointment.”

Amber traveled hundreds of miles to get prenatal and substance use care in New Mexico. She was fleeing a state with punitive policies for families affected by substance use. She was desperately searching for something she thought was too good to be true.

She found the compassionate care she was hoping for in our state. Amber was my patient and has allowed me to share her story.

Our governor recently mandated that hospitals report all substance-exposed newborns to the Children, Youth and Families Department and that babies undergo a 72-hour custody hold. As one of our state’s few perinatal substance use experts, I am ashamed of this misguided and dangerous mandate. I worry about patients like Amber, the ones I care for now and the ones I will never see as a result of the fear this stokes.

These punitive approaches have been trialed in other states and the research demonstrates harm. This shortsighted approach will not encourage people to seek substance use treatment and fewer mothers will be ready and stable to parent. Instead, they will avoid disclosing their use, seeking timely care and perhaps will even give birth outside of hospitals. There will be no incentive to discuss their addiction, because the fear of losing their babies will be too great. The very lives we hope to save will be threatened.

Such policies may lead to worse newborn withdrawal, higher rates of overdose, social isolation and suicide. Our efforts should fund programs that care for this population, because that’s where evidence shows improved outcomes. We need housing, health insurance, skilled providers, stigma-free settings and other resources. We need what Amber had.

“Over the course of the next few months, [the clinic’s] promise of being with me every step of the way proved profoundly true,” she said. “I found myself immersed in a network of resources I hadn’t dared to dream existed.”

In our state, I expect longer hospitalizations further crippling already strained hospital units. I expect an understaffed and under-resourced CYFD will be further stretched thin, exacerbating their inability to focus on cases that need more attention. I expect foster care will explode, forcing more children into dangerous situations, a reason ironically listed as prompting this policy development. Most importantly, I expect more suffering and death of pregnant/postpartum people. This attack will perpetuate racial and social disparities and generational trauma that already harm the families I care for. Our state’s Maternal Mortality Review Committee flagged substance use as a leading cause of pregnancy-associated death. The committee outlined recommendations to tackle this problem. This was not a solution. We should follow expert recommendations and the guidance of families with lived experience, not create and perpetuate dangerous fear-based tactics.

“They had boundless empathy and compassion, even during those moments when I had absolutely none for myself,” Amber said. “Their belief in me became a mirror, slowly reflecting back the possibility of who I could be for myself and for my child.”

The birth of a child is a moment that can bring about hope and healing. It is now being transformed into every parent’s worst nightmare. The state is weaponizing their biggest fear. Substance use should not to be equated to child abuse. Yes, it is a risk factor and a reason to instead surround these families in compassion and support. We need to garner hope for recovery, healing and unity.

“The day I gave birth to my son was a maelstrom of profound doubt, doubt in myself, doubt in the very system that now held my son’s fate in its hands,” Amber said. “The old, insidious questions clawed at me: Would they take him? Would my past define my future as a mother?”

Amber’s son was born with methamphetamine in his system, a reminder of the shadow she was trying to escape. She describes being enveloped “in care and support” from her clinical team coupled with a Plan of Safe Care, “a testament to collaborative, compassionate care designed to keep families together.” She was discharged with her son and received ongoing support. Today Amber is 18 months in recovery, raising her healthy boy. Amber is a testament to how we can approach this issue with compassion. This is the model that helps families thrive.