, 13 tweets, 7 min read Read on Twitter
Introduced this week in the Tennessee House, a new version of the fetal assault law. I'm going to write here about it's history, and why I'm worried. Hoping you will help me spread the word. @DrJenGunter @choo_ek #medtwitter #tweetiatricians wapp.capitol.tn.gov/apps/BillInfo/…
First, please don't attack my home state of Tennessee. Some on my twitter feed like to say negative things about my state ... it's not productive, it's insulting. The state is me, my family, colleagues and hundreds of public servants trying to do good.
Now to the history. From 2014 to 2016, Tennessee had a law on the books that a woman using a narcotic in pregnancy could be charged with a misdemeanor. It was essentially a special penalty just for pregnant women. tn.gov/content/dam/tn…
The worry we had as healthcare providers was that women would avoid care, deliver out of state or not go to hospitals. While the law was implemented, this did happen. wbir.com/article/news/l…
Proponents of the law suggest that it helps connect to treatment, but some of our research suggests that getting access to treatment can be difficult and may be even harder if you are pregnant. @SubstanceAbuseJ ncbi.nlm.nih.gov/pubmed/29949454
There's already such stigma substance use, especially for pregnant women, we should be doing things that make it harder. We know that treatment with medications like buprenorphine, reduce mom's risk of death & improves infant outcomes too (higher birth weights, longer gestation)
A 2 year sunset was put on the original law. It came up for renewal in 2016. On 3/15/2016 I testified in the state house in opposition along with others, including Duane Sloan a drug court judge. His testimony, I believe is the reason the bill died. wapp.capitol.tn.gov/apps/BillInfo/…
Not long after, we (me & @davida_schiff) published a statement from the @AmerAcadPeds entitled "A Public Health Approach to Opioid Use in Pregnancy" which reviews the evidence of similar policies, and proposes alternatives. pediatrics.aappublications.org/content/139/3/…
When the bill first past the Tennessee House it did so in part because no one knew about it. Even when the bill was up for reauthorization ... I was the only healthcare provider to show up to testify during the first hearing. I just don't want this to go unnoticed.
We can and should do better. Tennessee has done so many wonderful things to combat the #OpioidCrisis. We have amazing public health leaders. I believe HB1168 is the wrong approach and could be harmful to both moms & babies.
It's worth mentioning here our recent study in @JAMA_current that found community factors, including long-term unemployment, were associated higher rates of newborns having drug withdrawal. jamanetwork.com/journals/jama/…
... and the commentary by @katybkoz & @lindsayadmon that accompanied it jamanetwork.com/journals/jama/…
Taken together, the complexity of of substance use in pregnancy becomes slightly more evident. People don't just start using substances when they are pregnant, it generally starts well before ... and the reasons why are complex.
Missing some Tweet in this thread?
You can try to force a refresh.

Like this thread? Get email updates or save it to PDF!

Subscribe to Stephen Patrick, MD
Profile picture

Get real-time email alerts when new unrolls are available from this author!

This content may be removed anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

Follow Us on Twitter!

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just three indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!