For most parents, it is unimaginable to think that seeking medical care could lead to losing custody of their children, yet this devastating predicament is all too real for pregnant women with addiction in the United States. In our nation, the systems that aim to protect children from the negative effects of parental substance use often prioritize punitive approaches over proven public health strategies. Fear of being imprisoned, stigmatized, or having their children removed makes many pregnant women with substance use disorder (SUD) afraid to seek medical care, contributing to poor maternal health outcomes. Some state laws, including the law in Illinois where I practice medicine, even
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