Public Perception on Policies to Address Prenatal Substance use: Recommendations Regarding Maternal Criminal Prosecution and Child Welfare

Despite notable rates of neonatal alcohol and drug withdrawal, there is little consensus regarding best practices for legal intervention in the United States. Criminal and child welfare outcomes, and legislative efforts, have varied widely and occasionally resulted in unintended consequences. Following the Supreme Court of the United States' ruling overturning the constitutional right to an abortion ( Dobbs v. Jackson Women's Health Organization, 2022), U.S. citizens serve a more critical, yet understudied, role in influencing proposed reproductive rights legislation. Further, they may also serve as jurors in criminal cases involving prenatal substance use. To examine the general public's views, this study presented U.S. citizens (N = 467) with a hypothetical case vignette involving a mother who gave birth to a child in substance withdrawal. Participants provided recommendations regarding criminal prosecution and child welfare as a function of type of prenatal substance use. No statistically significant relationships emerged between substance type and criminal prosecution recommendations. However, with regard to child welfare, participants were significantly more likely to recommend loss of custody for prenatal heroin use and continued monitoring for benzodiazepine use. Secondary analyses revealed a relationship between participant political affiliation and criminal prosecution recommendation, such that Republican and Libertarian participants were more likely to recommend prosecution. With regard to child welfare outcomes, female participants and those who have been pregnant were more likely to recommend loss of custody. Lastly, trends in the general public's recommendations provide insight into public opinions that may inform approaches to policy and legal and clinical intervention.