When Jade Dass learned she was pregnant in 2020, she was excited – and worried. She was in recovery for opioid addiction using the treatment medication Suboxone. She didn’t have a job or stable housing. But she was determined to give her baby the best possible start in life. So she did what health officials and medical experts – from Arizona’s Medicaid agency to the CDC– said she should do: She continued using Suboxone, the gold standard for addiction treatment in the US. Staying on Suboxone during pregnancy leads to better outcomes for both mothers and babies, medical providers told her; stopping the medication could cause her to miscarry or give birth too soon, putting her baby at risk for developmental problems that could last a lifetime.
Dass didn’t realize that she could be reported to child welfare authorities, simply for following doctor’s orders. A few days after Dass gave birth to a healthy baby girl, an investigator for Arizona’s child welfare agency came to their hospital room and whisked the newborn away. Almost three years later, Dass still doesn’t have custody of her little girl, and chances are, she never will.
The story of what happened to Dass and her daughter is at the heart of reporter Shoshana Walter’s groundbreaking, and infuriating, 2023 investigation for Reveal, co published with The New York Times Magazine. Walter spent 18 months examining a federal law that has caused a reproductive Catch-22: Women in recovery are urged to take addiction-treatment medications to have healthy pregnancies. Then, all too often, they are reported for using those meds, triggering investigations and court involvement that can lead to babies being placed into foster care, sometimes indefinitely. Since 2016, Reveal found, thousands of women in recovery have been reported to child protective services for taking doctor-prescribed anti-addiction treatments – even when their meds kept them sober and their babies healthy. Women have also been reported for taking other prescription medications, such as antidepressants, anxiety and ADHD medicine, even fentanyl provided to women during childbirth.
The roots of this profound injustice can be found in America’s hostility toward women, especially mothers, who use drugs. Since the “crack baby” era of the 1980s, federal and state laws have required hospitals to report any baby born “affected by” illicit drugs to child welfare agencies; in many states, the language has been interpreted to include any babies exposed to drugs in utero, even if they weren’t “affected.” Then, in 2016, as opioid overdoses were skyrocketing, legislators on Capitol Hill quietly expanded that federal law to also require reporting of any baby who was “affected by” legally prescribed medications. Seven years later, Walter discovered, the revised federal law and state policies that followed have had sweeping, unintended consequences.
