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Competency 6: Legal Issues

Legal Issues Related to Women Who Drink During Pregnancy, Continued

Custody Issues

Child and father holding hands

Several States (e.g., Florida, South Carolina) take punitive measures toward alcohol use during pregnancy, such as including prenatal alcohol exposure in their definitions of abuse or neglect. Such measures can be used to remove the child from the parent’s custody. Texas allows involuntary termination of parental rights if a woman causes her child to be born addicted to alcohol. Generally, a mother who abuses substances may be charged with child neglect or abuse. As a result, her children may be taken from her.

In Virginia, physicians, nurses, teachers, and other professionals are required to report certain injuries to children. For purposes of the law, “reason to suspect that a child is abused or neglected” includes a diagnosis by an attending physician within 7 days of a child’s birth that the child has fetal alcohol syndrome attributable to in utero exposure to alcohol (Section 63.2-1509). One State, South Dakota, permits involuntary commitment Exit Disclaimer Graphic  of a pregnant woman who is drinking.

A number of experts fear that such punitive measures may discourage pregnant women with alcohol problems from seeking treatment. Many States (e.g., Arizona Exit Disclaimer Graphic, California Exit Disclaimer Graphic, Florida, Georgia, Illinois Exit Disclaimer Graphic, Missouri, Washington State Exit Disclaimer Graphic ) take a more supportive approach. They give pregnant women priority for alcohol treatment slots or otherwise provide access to treatment.

State and Federal governments have established various policies in response to the risks associated with drinking during pregnancy. Among these are various arrangemnents to increase access to substance abuse treatment by pregnant and postpartum women. Such arrangements include State-run treatment services, funding for private providers, and mandates that such women receive a priority for available treatment. The Alcohol Policy Information System (APIS) addresses statutes and regulations mandating priority access to substance abuse treatment for pregnant and postpartum women who abuse alcohol. Other measures designed to facilitate access to treatment by pregnant and postpartum women are beyond the current scope of APIS.

Another example, Washington State implemented the Yakima First Steps Mobilization Project for Pregnant Substance Abusers, known as First Steps PLUS (FS PLUS), is a demonstration project which began providing services in July 1993 and is funded by the Health Care Financing Administration under cooperative agreement No. 11-C-06108/0-02.

This project seeks to improve the health outcomes of pregnant substance-abusing women and their infants by enhancing existing perinatal services provided through Washington's First Step Maternity Care Program and by integrating and coordinating maternity care services with comprehensive substance abuse intervention services.

Key project objectives are to mobilize the community, especially medical practitioners, to the complex medical health, social and educational needs of low income, pregnant, substance-abusing women and to complete the continuum of care in the treatment of chemical dependency. More information about the project can be accessed at: www.dshs.wa.gov/pdf/ms/rda/research/7/71a.pdf Exit Disclaimer Graphic PDF Icon

Others (e.g., California) provide outreach or case management to pregnant women with substance abuse problems. California also may cover residential treatment for pregnant women under Medi-Cal. In addition, Iowa prohibits discrimination against pregnant women seeking alcohol treatment.

State statutes that remove custody from birth mothers of children with an FASD are designed to protect the children. However, the threat of losing custody or actually losing custody can interfere with the woman’s recovery. The goal is to remain sober long term and acquire parenting skills needed to retain child custody and have a healthy, intact family. The addiction professional needs to be familiar with laws in his or her State and their impact on efforts at family reunification and client recovery.

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