Pregnant women addicted to illegal narcotics or prescription pain pills could soon be jailed in Tennessee under a bill awaiting the governor's signature. The strict proposal enjoys bipartisan support despite objections from doctors.
The medical term for what happens when a newborn has withdrawal symptoms a day or two after birth is "neonatal abstinence syndrome." At its worst, these babies suffer from seizures; it's not clear whether there might also be lasting effects.
Tennessee last year forced every hospital to start reporting such cases, and the numbers have only been going up. As health officials have made drug-dependent babies a priority, the Legislature has taken a more punitive approach.
"It's always somebody else's fault," says state Rep. Terri Lynn Weaver. "What's wrong with: 'You screwed up, you're wrong, you've got to pay the consequences.' What's wrong with that?"
Weaver initially wanted to make it possible to charge women with homicide if their drug-dependent newborn died, but ultimately she had to tone it down. The women would now have the option to seek treatment.
"We can't make her get help herself," says Weaver, "but, by golly, we can give her an option and a choice."
Weaver is a conservative Republican, but Democrats jumped on board too. State Rep. John DeBerry admits it seems unnatural to punish a pregnant woman for harming her unborn child.
"We are always trying to save children who should be saved by their families, and I have said if there is a better way, bring it to me," he says. "I haven't seen it yet."
In some other states, prosecutors have gone after addicts whose newborn dies, trying to charge them with murder. Farah Diaz-Tello of the National Advocates for Pregnant Women points to a case in Mississippi.
"What Tennessee is doing is creating a law that would permit this kind of prosecution not for murder," says Diaz-Tello, "but it would allow for reckless endangerment, which is a misdemeanor, all the way up to aggravated assault."
And an assault charge could mean 15 years behind bars for the mother.
New mother Jackie Bains has returned to a Nashville women's clinic for a checkup. Her son is 7 weeks old and perfectly healthy. Bains says she was hooked on narcotic pain pills when she found out she was pregnant but she got help. She says it was hard to tell people, but it would have been even harder if she thought she could be punished for her addiction.
"I mean, some people are worried about going to jail and what it could do. But then you also have to worry about what it would do to the baby, too," she says. "I do think it will deter people from wanting to come in to seek help."
It's a concern that worries many in the medical community that the punitive approach, even with its treatment option, will drive away women or encourage more abortions.
Jessica Young, an obstetrician at Vanderbilt University Medical Center who specializes in drug treatment during pregnancy, says lawmakers don't fully understand that addiction can be a sickness.
"Being a poorly controlled diabetic is terrible for pregnancy probably equally as bad as drug addiction and we don't legislate those choices," says Young. "I just think this is an easy group to pick on because addiction has such a stigma."
Tennessee Gov. Bill Haslam, a relatively moderate Republican, has been hearing from women's groups around the country asking him to veto the bill, but he says he's comfortable with the final language, given that a woman always has a way to avoid jail time, even after giving birth to a child going through drug withdrawal.