When Keri McCallum‘s doctor prescribed her Suboxone, she was told it was the “safest thing for me.” It would aid her in her recovery from fentanyl addiction. It would, like it has for others, help change her life, McCallum said.
But, being pregnant with her second child, the Upton resident also experienced another impact of her prescription: It required she be reported to the state for potential child abuse or neglect.
“It’s this weird scenario,” said McCallum, 33, now four years sober and a recovery coach herself. A drug like Suboxone can help people become “productive members of society again. It helps them in recovery. Then you go and have a baby, and you’re being told you’re being abusive or neglectful.”
In Massachusetts, as well as other states, even the presence of a drug used to treat addiction — such as methadone and buprenorphine — automatically triggers a report to the Department of Children and Families. That reality, a Massachusetts General Hospital study found, prompts some mothers to consider stopping taking their medications and effectively punishes them with an “unjust and stigmatizing” mandate.
New federal legislation being pushed by Senator Edward J. Markey and others would shield pregnant or postpartum mothers from child abuse and neglect investigations solely for taking prescribed medication to treat substance use disorder. It would also block states from requiring health care professionals to notify child welfare officials about a mother if she’s taking a drug in “accordance with the recommendations of the prescribing practitioner” and the health care provider has no other reason to suspect that the child is in imminent danger.
The bill, dubbed the SAFE Recovery Act, would also bar states from requiring a toxicology screen of a mother unless she “gives clear and informed consent,” including being given access to interpreter services.
Currently, 26 states, and Washington, D.C., require health care professionals to report suspected prenatal drug use, according to the Guttmacher Institute, though it was unclear how many include an exemption for legally prescribed drugs. Eight require health care professionals to test for prenatal drug exposure if they suspect drug use.
The federal proposal could usher in a sea change to mandated reporting and mirrors efforts on the state level in Massachusetts, where lawmakers are also being asked to scale back at least part of its well-rooted law. McCallum’s experience is similar to other mothers, including Kayla Ford, a Worcester mother who spoke to the Globe in the spring about facing repeated DCF investigations despite being in recovery for six years.
A pair of legislative proposals on Beacon Hill has drawn the backing of doctors and the state-appointed child advocate and would end the mandate that medical professionals automatically report a mother to DCF for suspected child neglect because a baby is born exposed to an “addictive drug,” a list that includes medication to help treat addiction.
A legislative committee took testimony on the bills late last month, though it has yet to act on the proposals.
The goal of the federal bill, according to Markey’s office, is to create a more holistic approach to treating those who are pregnant or postpartum and are in recovery. Seeking treatment, Markey said, should make “parents and children safer, not less so.”
“We can’t accept a reality where parents are being separated from their children, stigmatized or threatened because they are getting the health care they need, recommended by a doctor,” the Democrat said.
Federal law mandates that states track data on all substance-exposed newborns, including exposure to legal substances, according to the MGH study.
But some states, such as Connecticut, have already taken different approaches, such as using “de-identified notifications” for newborns exposed to prescribed opioids and requiring child welfare reports only in cases when newborns are exposed to “non-prescribed” drugs, according to the study. In others, including New Hampshire and New Mexico, child protective service agencies are notified regardless, but a report of potential abuse or neglect is only filed for other safety risks.
That’s not the situation in Massachusetts. In McCallum’s case, DCF opened an investigation and ultimately monitored her for roughly a year after her son’s birth in April 2020, she said. She had been in the throes of fentanyl addiction when she had her first child roughly three years earlier, lost custody of her daughter, and, struggling with the guilt, fell “back even harder” into drug use.
Though she was in recovery by the time she had her second child, the fear of potentially losing her son consumed her.
“That’s why people use, to silence that fear. But every day it was, ‘Oh my God, are they going to take my baby? Do I have enough recovery time? Am I doing everything they want?” McCallum said. “It was around the clock. It was all I thought about. I think it was worse the second time around.”
McCallum and her cofounder, Kirsten Puccio, have since launched a Worcester-based nonprofit, M.I.R.A.C.L.E. Mamas, to help mothers in recovery. Removing the reporting mandate, she said, could help those in recovery “actually enjoy their pregnancy.”
“It’s supposed to be the most joyous occasion in their life,” she said. “But it’s often masked by this deliberating fear, that DCF is going to get involved and take their kid.”