Last week we signed on to an open letter to Gov. LePage, urging him to ensure that Maine’s policies regarding pregnant women and newborns are informed by science, and that they do not inadvertently endanger the health of babies.

The letter addresses some medical inaccuracies in an earlier weekly message by the governor about babies and drug dependency. We very much support efforts to ensure maternal, fetal and newborn health in Maine, but we want to make sure those efforts are rooted in science, not bias. To that end, we joined with several Maine physicians, health care providers, public health advocates and activists in signing the letter, the full text of which follows:

Open Letter Urging That Policies Addressing Pregnant Women 
and Opiate Use Be Rooted in Science, Not Stigma

November 25, 2013

Dear Governor LePage, 

We are writing this open letter in response to your email and radio address concerning "Drug-Dependent Newborns, a Disturbing Trend" (Nov. 13, 2013). We share your concern about the health and well being of Maine’s children and families. We are writing, however, to ensure that Maine’s policies regarding pregnant women and newborns is informed by science and that they do not inadvertently increase danger to the health of babies.
  • As this letter from leading medical experts makes clear, referring to newborns prenatally exposed to opiates as “addicted” is medically inaccurate and dangerously stigmatizing to newborns. We believe that being mislabeled as “addicted” at birth is no way to start life.
  • More than 40 years of research confirms that when babies show evidence of neonatal withdrawal, these symptoms are readily treatable, and there is no empirical evidence suggesting any long-term adverse consequences. There is no need for these newborns to “suffer” if medical staff are properly trained in the provision of care to pregnant women and newborns. In fact, leading national and international experts, including the federal Substance Abuse and Mental Health Services Administration, the World Health Organization, and the American College of Obstetricians and Gynecologists encourage opioid-dependent pregnant women to continue treatment, like methadone or buprenorphine, throughout their pregnancy.
  • Pain does not disappear when a woman becomes pregnant, and for women who are living with severe and chronic pain, opioid painkillers have been relied upon as the safest alternative. Denying pregnant women adequate pain treatment would not only be inhumane, but untreated pain during pregnancy would certainly present as a major stressor for pregnant women and their fetuses. 
  • Cost estimates from the cited JAMA study are misleading. The study did not evaluate whether those providing care were properly trained or whether they were following the well-supported protocols of rooming in and breastfeeding, both of which decrease the occurrence and severity of NAS. One study showed that only 11% of babies who boarded with their mothers required treatment of NAS compared to more than four times as many who were placed in a NICU. 
  • In order to be effective, policies addressing pregnant women and opioid use must include consideration of the medical, social, and economic factors that influence such use, as well as access to effective treatment for it.
  • Policies that are not rooted in science may result in denying pregnant women access to appropriate treatment for pain, creating barriers to medically approved and federally recommended opioid treatment, and increasing punitive and counterproductive child welfare interventions that undermine, rather than protect, children and families in Maine. 
  • The Snuggle ME Project was developed by Maine healthcare providers throughout the state specifically to improve outcomes for babies born to women who use or who are being prescribed opiates as part of medical treatment. It provides evidence-based guidelines for effective care of both mother and newborn.

We would very much like to join your efforts to ensure maternal, fetal, and child health in the state. To that end, we would be happy to provide you with access to national and international experts in the field of addiction treatment and we request the opportunity to meet with you to discuss this important issue.

Sincerely yours,

Kelly Bentley, Assistant Professor, Community Health Education, University of Maine-Farmington* 

Ann Kennedy, Associate Professor of Women's and Gender Studies, University of Maine-Farmington*  

Mark Publicker, M.D.

Connie Adler, M.D.

Mabel Wadsworth Women's Health Center

Family Planning Association of Maine

Gaelyn Aguilar, Assistant Professor of Anthropology, University of Maine-Farmington*

Sarah Brasslett, Bangor, ME

Lorrayne Carroll, Associate Professor of English, Women's and Gender Studies Faculty,   University of Southern Maine*

Chelsea Castonguay, Academic Support Coordinator, University of Maine-Orono*

Wendy Chapkis, Professor of Sociology &Women & Gender Studies, University of Southern Maine*

Lucinda Cole, Director of Women's and Gender Studies, University of Southern Maine*

Jen Jack Giesing, New Media and Data Visualization Specialist, Bowdoin College*

Nancy Gish, University of Southern Maine*

Sandra S. Haggard, Associate Professor of Biological Sciences UMA-Bangor

Allison Hepler, Professor of History, University of Maine-Farmington*

Andrea Irwin, Esq. 

Polly Kaufmann, Department of History, University of Southern Maine*

Nicole Kellett, Assistant Professor of Anthropology, University of Maine-Farmington*

Susan K. Riley, Advocacy Committee, Mabel Wadsworth Women’s Health Center

Ann Schonberger

Lauren Webster, University of Southern Maine*

Shana Youngdahl, University of Maine-Farmington*

Members of Maine Grandmas for Reproductive Rights (GRR!)

            Julia G. Kahrl 

            Janice Miranda

            Beedy Parker

            Kitty Wheeler

            Jay McCreight

            Lucy Stinson

ACLU of Maine

National Advocates for Pregnant Women

*this person signs as an individual and title and work information are for identification purposes only

 cc: Commissioner Mary Mayhew of the Department of Health and Human Services