Bell, Lee and Peacock-Chambers are among a broad coalition of people who’ve been lobbying Massachusetts to change the state’s law, arguing that it harms patients, women, and the children it purports to protect.
This year, a new bill to remove prenatal substance exposure as an automatic 51A report trigger began making its way through the legislative process, with the support of the Massachusetts Medical Society, Boston Medical Center and other doctors’ groups. Nationally, leading medical associations oppose punishment as a response to drug use during pregnancy.
The bill is one part of a wave of efforts nationwide to end punitive laws targeting people who use drugs during pregnancy. An effort is also underway in New York to fight drug testing of pregnant people without informed consent, and in Wisconsin the National Advocates for Pregnant Women is legally challenging charges of child endangerment against people who use drugs during pregnancy.
Ultimately, Nikki Bell’s 51A claim was dismissed last year. But the weeks-long investigation was “very invasive in an already difficult time,” she says.
That invasiveness may partly explain why relatively few people sign up for Massachusetts’ free early intervention programs, in which counselors support opioid-exposed children with regular home visits. In theory, participating in this kind of voluntary program makes families more likely to retain or regain custody of their children. It can also provide much-needed childcare help.
But for many, allowing more clinicians into their lives feels too risky.
“I always had a fear that you couldn’t be too honest,” one Massachusetts mother told Peacock-Chambers and her colleagues in a 2020 study on how parents of opioid-exposed perceive early intervention services. “Like, I know you guys are mandated reporters.”
“That fear,” says Peacock-Chambers, “comes from a very evolutionarily primal place: a fear of having one’s child taken.”