Last month’s Supreme Court decision to strike down Roe v. Wade denied people who can get pregnant one of the most fundamental rights to bodily autonomy, turning back the clock on nearly 50 years of precedent. And while we are still trying to figure out all of the potential consequences and implications of Dobbs v. Jackson Women’s Health Organization, one clear outcome will be increasingly dire and unsafe circumstances for people who use drugs.
Like abortion restrictions and bans, drug prohibition has always been a key front of the attack on pregnant people’s rights. The drug war already targets, demonizes and criminalizes pregnant people. Our health, civil and criminal-legal systems commonly use actual or even suspected drug use as justification to punish pregnant people, instead of helping them. The measures range from criminalization to forced drug testing to children being taken from their families and placed in the family regulation system. Now, the ramped-up attack on reproductive justice will only worsen these devastating harms.
The reversal of Roe will hit the most marginalized and vulnerable people the hardest. Many people will not have the means to travel out of state. And pregnant people who use drugs, especially Black and Brown people experiencing poverty and criminalization, face the greatest risk of being cut off entirely from basic bodily autonomy and reproductive care.
Pregnant people—especially people of color and people experiencing poverty—are constantly targeted by drug screenings, often without consent.
Pregnancy does not necessarily change pre-existing behaviors or conditions. And when people who use drugs become pregnant, whether or not they are experiencing addiction, they are routinely villainized due to the drug war’s misinformation and stigma.
Pregnant people—especially, once again, people of color and people experiencing poverty—are constantly targeted by doctors who conduct drug screenings on them, often without consent. Racism is inherent to this practice: Research shows that Black women and their newborns are 1.5 times more likely to be tested for illicit drugs than non-Black women. Fueled by the drug war and sensationalized media portrayals of “crack babies”—a myth that lives on, despite being disproven—this targeting causes immense harm to pregnant Black people, children and communities.
Child protection is the supposed justification. Yet there is no plausible evidence that drug use of any kind results in birth complications. Multiple studies have dispelled myths of harms done to a fetus by drug use. A study by researchers at Columbia University found no correlation between marijuana use and impaired cognitive function in fetuses. In fact, many states allow for the use of medical marijuana during pregnancy.
“While there are numerous studies reporting findings that certain substances may increase a particular risk of harm, such as [lower birth weight], research has not found that any criminalized substances are abortifacients, cause miscarriages or stillbirths, or cause specific harms or impairments to the children prenatally exposed,” states National Advocates for Pregnant Women (NAPW). “In general, the risks associated with prenatal exposures to any of the criminalized drugs have been found to be comparable to or less than those associated with legal substances much more commonly used.”
The renewed war on bodily autonomy will be taken to legitimize harmful practices, putting even more Black and Brown pregnant people in the crosshairs.
As NAPW also notes, a person’s drug use “tells us nothing about that person’s ability to parent.” Despite this, parental drug use (including alcohol) was cited as a contributing factor for child removal in 38.9 percent of cases in 2019—more than twice the frequency of 2000 (18.5 percent).
There’s no doubt that the renewed war on bodily autonomy will be taken to legitimize harmful practices, exacerbating existing racial disparities and putting even more Black and Brown pregnant people in the crosshairs. With millions losing access to abortion care, it’s highly likely that we’ll see a big increase in the drug testing of pregnant people, which will inevitably lead to increased criminalization and more children being taken away from their families. Foster care systems, child protective services and carceral institutions will see spikes in their caseloads. And the drug war has taught us only too well how our health, civil, and criminal-legal systems place people who use drugs, and pregnant people, at further risk.
Criminalization and punishment are not the answer to addiction or drug use, and they are certainly not the answer to pregnancy, abortion or miscarriage. Human suffering and human tragedies are the result. Take the case of Chelsea Becker, a woman in California who used methamphetamine. After delivering a stillborn baby in 2019, she was arrested for murder. Instead of receiving support during a traumatic time, she was thrown in jail. It took until 2021 for the murder charge to be dismissed.
How many more stories like Chelsea Becker’s will spring from the Supreme Court’s decision, and the movement it represents that prioritizes punishment over care?
While it may seem like we’ve lost the fight for the moment, we haven’t lost the war. We must stand strong with pregnant people everywhere, especially those who use drugs, and insist on their right to safe, non-judgemental care. We must fight for their right to make their own choices, based on what’s best for them and their circumstances. Supporting those choices, as many entities are now mobilizing to do, might mean supplying abortifacients, or ensuring safe passage to jurisdictions where rights remain intact, or developing and sustaining other forms of mutual aid.
We know that pregnant people, especially those who use drugs, are under attack. But just as we have responded to decades of attacks on lifesaving harm reduction services, we can and must respond to the resurgent war on bodily autonomy and reproductive justice.
The Drug Policy Alliance, where the authors intern, previously provided a restricted grant to The Influence Foundation, which operates Filter, to support a Drug War Journalism Diversity Fellowship.