Bill Proposes Mandatory Drug and Alcohol Testing of Suspicious Pregnant Women in Tennessee

A bill was just introduced to the Tennessee state legislature that would mandate drug and alcohol testing for certain pregnant women. And not only that—any such woman who then failed to show up to two subsequent prenatal exams would be reported to the department of children’s services. You can find the full text of the bill at the link above, or find it pasted here, on the informative website Women’s Health News.

According to the proposed bill, which behaviors signal that you are a pregnant woman of interest who can be forced to have drug or alcohol testing? The following:

(1) No prenatal care;
(2) Late prenatal care after twenty-four (24) weeks gestation;
(3) Incomplete prenatal care;
(4) Abruptio placentae;
(5) Intrauterine fetal death;
(6) Preterm labor of no obvious cause;
(7) Intrauterine growth retardation of no obvious cause;
(8) Previously known alcohol or drug abuse; or
(9) Unexplained congenital anomalies.

Where this list is vaguest is also where it’s most alarming. What exactly is “incomplete prenatal care”? Who defines it? And who, after all, goes without prenatal care? Often, it’s poor women, marginalized women (perhaps immigrant, illegal, or lacking English skills) and uninsured women.

I suppose it’s no surprise that merely being poor means you are, by default, of dubious character in our by-the-bootstraps culture, which often promotes the idea that if you’re poor, you must deserve to be. All women should have prenatal care. But is assuming that women who don’t get prenatal care are substance abusers the way to do it?

To continue with the troubling vagueness: There isn’t always an explanation for preterm labor, nor for every congenital anomaly. According to the National Institutes of Health, intrauterine growth retardation is associated with heart disesase, high altitudes, carrying multiples and having preeclampsia, poor nutrition, infections such as rubella and toxoplasmosis—and substance abuse. Abruptio placentae, which means the premature separation of the placenta from the uterus, has been tied to the use of cigarettes and crack—but also to such risk factors as high blood pressure or diabetes, suffering trauma (say, from being in a car accident), being over 35 or carrying a male fetus.

I’m 36 and carrying a boy. If I were in Tennessee and were unlucky enough to suffer abruptio placentae—and survive it, since it can kill both mother and child—I could then be subjected to a mandatory drug test. Because how can a doctor know for sure that my age is the cause without eliminating the possibility of substance abuse? It just doesn’t add up. And the bill doesn’t require doctors to test for all of these other causes before asking a woman to pee in a cup.

So say a woman tests positive for alcohol or drugs. What happens next, according to this proposal?

Every physician, surgeon or other person permitted by law to attend a pregnant woman during gestation shall report each woman who refuses to seek treatment for an alcohol-related or drug-related problem or who misses two (2) or more appointments to the department of children’s services.

What happens after that is left unexplained. Are they brought up on criminal charges? Do they lose their children upon giving birth to them?

This law would seem to open up the possibility of sweeping up a whole bunch of people who aren’t substance abusers. It’s ironic that the only way some of these Tennessee women are going to get prenatal care is by being considered a potential threat to their own unborn children.

We can all agree that substance abusers are endangering their unborn children. But a violation of many women’s civil rights doesn’t seem to me the way to intervene.