How Substance Use Became a Trojan Horse to Undermine Abortion Rights

Fetal alcohol spectrum disorder is being weaponized by the right in the reproductive rights wars—and putting fetuses at greater risk.

In the first two years of post-Dobbs America, 412 people were charged with “pregnancy-related” crimes, with 399 of these being related to substance use—including alcohol. These charges, which most frequently alleged either child abuse or neglect of the fetus, were made possible by politicians who have slow-dripped the language and ideology of fetal personhood into lawmaking for decades, a process that has only amplified since the overturning of Roe v. Wade.

For years, anti-choice lawmakers have sought to lay down legal precedents for fetuses and embryos to be considered fully fledged persons in need of legal protections as part of a wider framework to criminalize abortion as murder. But this language and this broader approach to so-called public health have ramifications beyond abortion: If a fetus is a person, then consuming alcohol or narcotics while pregnant and putting the fetus at risk for fetal alcohol spectrum disorder, or FASD, and other substance-related birth defects is a form of child endangerment.

Not only does this result in the criminalizing of pregnant people, it also hinders the prevention, research, and treatment for both the FASD and substance use disorders being weaponized to advance this anti-abortion agenda. What’s more, this ideology has proven to be wholly ineffective in the effort to “protect fetuses.” Laws around “pregnancy-related crimes” have only prevented mothers from seeking support, while simultaneously creating legal frameworks for restricting abortion access, creating a climate where pregnant patients are increasingly policed and where public health policies around prenatal substance exposure, FASD, and reproductive justice movements are increasingly linked.

Dr. Sarah Roberts is a professor and legal epidemiologist at the Advancing New Standards in Reproductive Health initiative at the University of California at San Francisco, and one of the only researchers in the United States working on the intersections of health care practices and policies around abortion and the criminalization of behaviors while pregnant. “Singling out drinking while pregnant isn’t effective,” she explains, noting that none of the punitive or so-called “supportive” FASD prevention policies that she’s analyzed actually prevented FASD.

The only policies that actually prevented FASD and offered support to mothers and babies with FASD were those that addressed alcohol consumption across the board.........

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