ReviewAmerican journal of obstetrics & gynecology MFM2020
Consensus Guidelines and State Policies: The Gap Between Principle and Practice at the Intersection of Substance Use and Pregnancy.
Review in American journal of obstetrics & gynecology MFM, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Barriers to opioid replacement therapy in pregnant women with opioid use disorder: a systematic review.Substance abuse treatment, prevention, and policy · 2025Pooled it
- Punitive legal responses to prenatal drug use in the United States: A survey of state policies and systematic review of their public health impacts.The International journal on drug policy · 2024Pooled it
- Prospective observational study quantifying maternal-fetal fentanyl transmission in epidural analgesia infusion using umbilical cord blood and neonatal meconium.Journal of perinatology : official journal of the California Perinatal Association · 2026Observational
- Impact of policies on pregnant individuals using drugs: A narrative synthesis review of treatment, health care access, and outcomes.Stigma and health · 2026Article
- Navigating opioid use disorder treatment for pregnant and parenting people: composite narratives for policy action.Substance abuse treatment, prevention, and policy · 2026Article
- Perspectives of professionals on the perinatal period as a window of opportunity for change in women with SUD: insights from healthcare, child welfare, substance use, and child protection services.Frontiers in psychiatry · 2026Article
- Peripartum substance use and punitive laws: an update.Archives of women's mental health · 2025Article
- Tailored strategies to reduce opioid overdose deaths for pregnant and postpartum women: Examples and lessons learned from the HEALing Communities Study.Journal of substance use and addiction treatment · 2025Article
- Connecticut's Novel Prenatal Substance Exposure Policy Is Associated With Declining CPS Reports And Foster Placements.Health affairs (Project Hope) · 2025Article
- A cross-sectional study of differences in medication for opioid use disorder receipt among pregnant people enrolled in Medicaid in Oregon, United States.Addiction (Abingdon, England) · 2025Article
- State Policy Variation in Implementation of Federal Drug and Child Abuse Laws and Stigmatization of Pregnant and Postpartum Individuals with Opioid Use Disorder.Journal of women's health (2002) · 2025Article
- State Child Abuse and Mandated Reporting Policies for Prenatal Substance Use and Congenital Syphilis Case Rates: United States, 2018-2022.American journal of public health · 2025Article
- Severe Maternal Morbidity Among Pregnant People With Opioid Use Disorder Enrolled in Medicaid.JAMA network open · 2025Article
- Documentation of Stigmatizing Language in Electronic Health Records and Birth Outcomes.Health equity · 2025Article
- Substance Use-Associated Infant Maltreatment Report Rates in the Context of Complex Prenatal Substance Use Policy Environments.Child maltreatment · 2024Article
- Association of psychiatric and substance use disorders with cannabis use and cannabis use disorder during early pregnancy in northern California.Addiction (Abingdon, England) · 2024Observational
- Reviewing the Impact of Maternal Opioid Use Disorder on Fetal Development and Long-Term Pediatric Health Outcomes.Cureus · 2024Review
- Addressing Children and Families within the National Drug Control Strategy.Parenting, science and practice · 2024Article
- Patient perceptions of and experiences with stigma using telehealth for opioid use disorder treatment: a qualitative analysis.Harm reduction journal · 2024Article
- Recruitment and retention strategies to promote research engagement among caregivers and their children: A scoping review.Journal of clinical and translational science · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
The opioid crisis has had a substantial effect on women who are pregnant and parenting, focusing both public health and policymaker attention on opioids and on other substance use in pregnancy and postpartum. There is overwhelming consensus on the principle of a non-punitive approach towards substance use in pregnancy. Experts universally endorse supportive policies, which reduce barriers to care, and oppose punitive policies, which can increase the fear of legal penalties, discouraging women from seeking prenatal care and addiction treatment during pregnancy. We review the change over time in state-level policy environments around substance use in pregnancy and contrast the policy response with the principles and guidance from professional societies and federal agencies. Between 2000 and 2015, more states adopted punitive policies than supportive policies, in direct contrast with guidance from professional societies and federal agencies. The increase in punitive policies over the past two decades suggests that the gap between principles and practice is widening. Furthermore, the increase in punitive policies is occurring in the context of significant structural barriers to comprehensive health care across the woman's entire life course, a growing awareness of racial and ethnic inequities in maternal morbidity and mortality, and increasing restrictions at the state level on abortion access. Women with substance use disorder (SUD) need comprehensive, coordinated, evidence-based, trauma-informed, family-centered care. This care should be delivered in a compassionate and non-punitive environment, and clinicians, policymakers, and public health officials all have a role to play in achieving this goal.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.