Substance Abuse Policies and Prenatal Health Behaviors: Do Punitive Policies Improve Birth Outcomes and Increase Prenatal Care?

Christine Coyer, Cornell University

Recent high-profile court cases and actions by state legislatures to criminalize drug use during pregnancy have drawn national attention to substance abuse policies in the United States. Although punitive policies (e.g., civil and criminal child abuse laws) are gaining favor, very little is known about the impact of these policies on health behaviors and on birth outcomes. I use the variation in the timing of substance abuse policy implementation across states from 1985 to 2000 to study the effects of punitive substance abuse policies on birth outcomes and on the receipt of prenatal care. I find that civil child abuse laws decrease average birth weight by 33.5 grams and they increase the probability of early gestation by 0.7 percentage points. I also find that they decrease the probability of any prenatal care by 2.4 percentage points and they decrease the probability of initiating prenatal care during the first trimester.