I can’t claim to understand what it’s like to be pregnant and addicted to drugs—let alone pregnant and addicted to drugs with an overwhelming desire to carry the child to term. But we live in a world where it’s extremely controversial for me to even suggest the option of terminating a pregnancy, so I won’t go there.
Where Should We Draw the Line?
Here’s where I will go: an article posted in Truthout recently discussed the consequences some women have endured after disclosing to heath care professionals about being on medication-assisted treatment (MAT) for addiction while pregnant. The fact it represents the phenomenon as a travesty of justice caused my jaw hit the floor. The story introduces the question—Is MAT while pregnant practicing harm reduction? And, does it excuse the woman from the consequences that would face any other mother who tested positive for opiates?
As a recovering alcoholic, an advocate for erasing the stigma of addiction and a Jew, I hate to think of myself as a conservative. But the idea that, as a society, we are being asked to ease up on getting authorities involved when a woman gives birth to a potentially drug-addicted baby is where I draw the line.
Taking Opiates While Pregnant
This particular article is extremely vague and seemingly very biased about the facts of each case. The first woman, Kimberly Byrnes, claims she was treated unfairly after being honest about using Subutex—opiate is intended to help wean off more lethal opiates—for several years, including while pregnant. After she gave birth, she was surprised when the hospital had the nerve to open an investigation with the Department of Children and Families (DCF). So, let me get this straight. A woman who has been on MAT for years, which could be perceived as having no intentions of getting off of it, feels that it’s unreasonable for the government to investigate the welfare of her newborn child? This standpoint alone makes me suspect of her competence as a parent.
But I get it, she was more than likely told by her MAT administrator or treating physician that taking buprenorphine while pregnant was safe—at least safe as opposed to taking methadone or slamming heroin. However, it is still a Category C risk, according to the FDA, which means that there is enough of a risk of harm to the fetus that it’s potential effects can’t be overlooked. This is exactly why DCF needs to be notified and an investigation should be conducted. Byrnes should know this isn’t about being wrongfully stigmatized as a drug addict, it’s about the facts: that she potentially put her unborn child at risk for complications by taking an opiate while pregnant.
The Consequences of Our Actions
So, while I very much support second, third and fourth chances, there are things that happen in life that can’t be undone. Anyone and everyone—addict or not—has experiences they wish they could forget or go back and undo. Of course, getting a bloody nose during your high school debate competition probably isn’t going to incite a post-natal investigation. But my point is, we can be forgiven for our transgressions but it doesn’t mean we get to skirt the consequences. Part of being a person in recovery is the willingness to face the wreckage of our past. It seems unreasonable to feel entitled to anything else.
What is unclear in this article (for good reason I assume) is the exact risks, if any, facing the unborn child of a mother taking Subutex. There is no mention of the the child being born addicted to drugs. The article also makes no mention of what the protocol is if a baby is born opiate dependent and what challenges that child may be up against moving forward.
No Longer About You
Truth be told, I don’t know how I feel about MAT or harm reduction tactics in general. But I do know that when you become a parent, your choices are no longer just about you. They should start being about what is best for your child. More than anything, this article feels like it is advocating for women to make choices based on what is best for them. As Joelle Puccio, the director of women’s services at The People’s Harm Reduction Alliance in Seattle noted, “harm reduction means we don’t assume we know what is best for someone. We assume that each person knows what’s best for themselves, and we ask them.” But alcoholics and drug addicts are notorious liars and are often singularly motivated by their addiction, so how can they be trusted to know what is best for them—let alone their unborn child?
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