Perinatal Substance Use

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Perinatal Substance Use

Substance use during pregnancy remains a significant public health concern. Research suggests that prenatal exposure to drugs, coupled with a chaotic postnatal environment, has detrimental effects on a child’s social-emotional, cognitive and behavioral development. Early intervention programs and state and federal policies have been developed to meet the needs of these infants.

Public Policy

Federal Policies

In July 2003, the federal government made an attempt at removing some of the inconsistency in state policy approaches to substance exposed newborns (SEN) through an amendment to the Child Abuse Prevention and Treatment Act (CAPTA). This amendment is intended to encourage Child Welfare Services (CWS) linkage with developmental, mental health, early intervention and health services in order to access supportive help for at-risk children. Under the new CAPTA requirement, states must have in place:

1. Policies and procedures to address the needs of infants born and identified as being affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure, including a requirement that health care providers involved in the delivery or care of such infants notify the child protective services system of the occurrence of such condition in such infants.

2. The development of a plan of safe care for the infants born and identified as being affected by illegal substance abuse or withdrawal symptoms.

Learn how four federally funded demonstration projects have addressed these CAPTA requirements in a webcast hosted by the National AIA Resource Center in September 2009: Collaborative Approaches to Identifying and Serving Substance Exposed Newborns: Lessons Learned from Four Demonstration Projects

State Policies

Even prior to the passage of the SEN-related CAPTA amendments and the federally funded demonstration projects, states had begun to address these issues from various angles. Some states have focused on the identification of and services for pregnant substance users; others have focused on the identification of substance exposed newborns; and still others have focused on service provision for substance exposed newborns.

Here is an overview of policies throughout the US: State Policies in Brief – Substance Abuse During Pregnancy (Guttmacher Institute) [PDF]

Below are links to documents providing insight into the approaches taken and policies developed in various states:




AIA projects have developed the following protocols:



  • March of Dimes
    March of Dimes provides direct services, health education, advocacy and research to help mothers have full-term pregnancies and healthy infants.
  • National Perinatal Association (NPA)
    NPA promotes the health and well-being of mothers and infants through collaboration, education, advocacy and leadership.