Walking a tightrope: states are balancing the rights of addicted women with the health needs of their developing babies.

• Author: Wile, Margaret
• Position: HEALTH CARE

Every three minutes, a woman shows up at an emergency room because of prescription drug misuse or abuse. Some of them are pregnant. And when they are, and they've been using opioids, it can mean death for the mother and painful withdrawal for the baby. A woman's risk of dying during delivery increases fourfold if she is misusing or dependent on opioids, the American Society of Anesthesiologists reports.

It's a S1.2 billion problem for states.

The devastation caused by opioid addiction is widely known. More than 33,000 people died from opioid-related overdoses in the United States in 2015, according to the Centers for Disease Control and Prevention.

Babies born "substance exposed" tend to eat and sleep poorly, potentially harming their development. The average hospital price tag to treat one of these babies is $93,400, the CDC estimates. The total annual cost in 2012 (the latest figures available) for caring for these newborns was $1.5 billion, of which $ 1.2 billion came out of state Medicaid budgets.

The consequences of addiction extend beyond mothers and babies to families, communities and states.

This is a national problem.

As this population of mothers grows, the challenge is protecting mothers' rights while guarding the well-being of their future children. Some state legislatures and health departments are working hard to find a balance.

Pre- and Postnatal Care Is Vital

An estimated 86 percent of pregnancies among women who misuse opioids are unintended, and many don't receive early or adequate prenatal care. A lack of prenatal care puts both mother and baby at risk. The chance that a baby will die before the age of 2 months is five times greater when a mother does not receive prenatal care than when she does, according to the Journal of Obstetrics and Gynecology. Lack of prenatal care also is associated with lower birth weight babies.

After the baby is born, the new mother and child still face dangers, especially when the mother is no longer covered by insurance or is unable to obtain daily maintenance medication, such as methadone. The National Institutes of Health recommend a daily dose of methadone for pregnant women who are trying to quit using opioids. Methadone is one of three medication-assisted treatments approved by the FDA. It reduces withdrawal symptoms and relieves the cravings associated with addiction without causing the euphoric and sedating feelings produced by opioids.

The rates of maternal death directly linked to opioid use and abuse continue to increase, the CDC reports. Accidental overdoses were the...