An Oklahoma nonprofit says pregnant mothers with substance use disorders need safer pathways to treatment, not criminalization.
Metriarch is a nonpartisan research and policy group focused on improving women’s health in Oklahoma. The organization detailed the disconnect between the state’s punishments for pregnant women with substance use disorders and the care recommended by health experts and researchers in “Paths To Recovery.”
Published in June and promoted at a state capitol event in October, Metriarch’s report includes interviews, public health data and analysis that culminates into four policy recommendations for legislators to consider during the 2026 Oklahoma legislative session. Lawmakers convene Feb. 5.
“There are so many solutions that are cheaper on taxpayer dollars, they keep women in the workforce, they keep women with their families and they keep kids out of the foster system,” said Caitlin Beasley, policy engagement manager at Metriarch.
The number of pregnancy-related charges brought against women in Oklahoma is growing, according to the report’s findings. Of the 227 cases Metriarch researchers identified since 2006, more than half occurred after June 2022. Women testing positive for controlled or illegal substances in Oklahoma have faced felony child neglect charges, which carries a potential life sentence, the report states.
Eliza Washington-Harris, Metriarch’s data and research analyst, said the intersection of the state’s criminal justice and health care systems can leave pregnant women with substance use disorders in a catch-22.
“In the end, you have a system where because of that criminalization, people are afraid to seek care,” Washington-Harris said. “They’re afraid to seek substance use care because they’re pregnant, and they’re afraid to seek prenatal care because they have substance use disorder.”
Four policy changes could improve health outcomes for moms and babies
Ensuring women with substance use disorder feel safe seeking help is the top priority among Metriarch’s four policy recommendations.
“People have to trust that they won’t be put in prison for asking for help,” Beasley said.
The second policy recommendation is ensuring pregnant women have access to tailored mental health treatment services and medications.
Researchers called several treatment centers that claimed they provided services to pregnant women but were often answered by receptionists who were unsure whether they could.
“That’s part of it — making sure that these treatment centers have the adequate training to meet someone at that first point of contact, when they are at a really vulnerable stage, but also a stage where they are most likely to be able to make a change in their lives, in their lifestyle and behaviors,” Washington-Harris said.
Once pregnant women with substance use disorders get access to treatment centers, it’s important they have access to trained physicians, Washington-Harris said. Researchers found physicians are often averse to providing medications for opioid use disorder to pregnant women.
The third recommendation is establishing and expanding early intervention and prison diversion programs that prioritize or specialize in serving pregnant, postpartum and parenting women and their children — especially in rural areas.
“The western part of the state, pockets in the southeast — there aren’t programs there,” Beasley said. “And even if there are substance use disorder treatment programs, they don’t have the kind of programming that we know works with this population.”
The final recommendation is promoting early pregnancy detection and culturally competent, harm-reduction informed prenatal and postpartum health care for mother and child.
Due to the state’s abortion laws and stigma surrounding substance use disorders, Beasley said many women with addiction issues are often afraid to get a confirmatory pregnancy test. Due to the complicated cultural and legal factors, this was Metriarch’s last recommendation.
“I think that’s why it’s probably our bottom bucket, because it’s the furthest away,” Beasley said. “It’s not that it’s not important. It’s just in our current environment, there are some risks associated with it.”
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