Research Spotlight: Prenatal Substance Use Policies and Infant Maltreatment Reports

Danielle Atkins, Ph.D., Associate Professor of Public Administration at Florida State University, co-authored an article in the journal Health Affairs titled “Prenatal Substance Use Policies and Infant Maltreatment Reports” with Johanna Catherine Maclean, Ph.D., Allison Witman, Ph.D., Christine Piette Durrance, Ph.D., and Angelica Meinhofer, Ph.D. Below is a summary of the article written by doctoral student Martin Gandur (Ph.D. Political Science ’25).   

In “Prenatal Substance Use Policies and Infant Maltreatment Reports,” FSU Associate Professor of Public Administration Danielle Atkins, Ph.D., and co-authors examine how punitive and support state prenatal substance use policies influence reports of infant maltreatment to child protective agencies.

This study provides the first evidence of the impact of prenatal substance use policies on infant maltreatment reports and has important policy implications.

The authors discuss that while punitive policies criminalize prenatal substance use, define prenatal substance exposure as child maltreatment in child welfare statutes, or are used as grounds for termination of parental rights, supportive (or priority treatment) policies provide pregnant people with priority access to substance use disorder (SUD) treatment programs, which professionals in the field have identified as best practice for addressing prenatal substance use.

The authors collected administrative data on child maltreatment reports from the National Child Abuse and Neglect Data System, using statistical analyses to evaluate the relationship between prenatal substance use policies and infant maltreatment reports.

The data include total reports, substantiated reports (those that meet the definition of child maltreatment), unsubstantiated reports (those that do not meet that definition or have insufficient evidence), and substantiated reports in which the mother was the alleged perpetrator. Finally, the authors also collect data about states’ adoption of prenatal substance use policies (punitive, priority, or no policy).

The results show that punitive prenatal substance use policies increased total and substantiated infant maltreatment reports.

The authors assert that states should design interventions that emphasize support services and prioritize the connection between mothers and infants in alignment with primary policy goals: strengthening families and improving well-being for all.