Prenatal Substance Use Policies and Infant Outcomes

Substance use during pregnancy can cause severe, life-long harm to the baby. According to the National Survey on Drug Use and Health (2011), 5% of pregnant women aged 15-44 reported using illicit drugs, 9% reported using alcohol, and 17% reported using cigarettes. Tennessee was the first state to criminalize prenatal substance abuse in 2014. In other states, considerable variation over time exists in how prenatal substance use is handled by the law. For example, prenatal substance use is treated as child abuse in many states. Other states provide drug treatment programs specifically for pregnant women. Policy data is drawn from the Guttmacher Institute’s State Policies in Brief: Substance Abuse During Pregnancy. In this paper, we use a difference-in-difference approach to investigate the effect of state-specific policies on prenatal substance use and consequences for newborn health, focusing on several outcome measures. Outcomes include infant health and drug dependency at birth (HCUP), inpatient treatment admissions (TEDS), prenatal care initiation and utilization (PRAMS), and maternal alcohol and smoking behaviors during pregnancy (PRAMS).