Women with opioid use disorder (“OUD”) are more likely than other women to experience sexual assault, unintentional pregnancy, transactional sex and coercion regarding reproductive health care choices than women without OUD. Laws described as family friendly may be punitive rather than helpful to women and rarely apply to men. Laws regarding reproductive health and OUD are unevenly enforced and therefore biased against poor, minority women. As part of a larger study oriented toward strengthening systems of care related to the intersection of HIV and OUD, we conducted an analysis of state laws related to pregnant and postpartum women with OUD. Data on disparities in child removals and pregnant women’s use of evidence-based treatment for OUD by income and race were captured for the five states with the most restrictive laws in both categories. Laws that were purportedly designed to improve reproductive health outcomes for women with OUD and/or their children often have the opposite of the expressed intended outcome. There is a relationship between restrictive reproductive choice and coercive OUD treatment policy for women. Restrictive state regulations for pregnant women with OUD persist despite negative outcomes for maternal and child health. Altering coercive and/or criminalizing regulation and redefining ‘family friendly’ may improve outcomes for individuals and families.

中文翻译：

---

孕妇和阿片类药物使用障碍：检查控制妇女生殖健康的法律环境

与没有 OUD 的女性相比，患有阿片类药物使用障碍 (“OUD”) 的女性比其他女性更容易遭受性侵犯、意外怀孕、性交易和生殖健康护理选择方面的胁迫。被描述为家庭友好的法律可能是惩罚性的，而不是对女性有帮助，而且很少适用于男性。有关生殖健康和 OUD 的法律执行不均，因此对贫穷的少数民族妇女存在偏见。作为旨在加强与 HIV 和 OUD 交叉相关的护理系统的更大规模研究的一部分，我们对与患有 OUD 的孕妇和产后妇女相关的州法律进行了分析。在这两个类别中法律最严格的五个州收集了关于儿童迁移和孕妇使用基于收入和种族的循证治疗 OUD 的差异的数据。据称旨在改善患有 OUD 的妇女和/或其子女的生殖健康结果的法律往往与所表达的预期结果相反。限制性生育选择与针对女性的强制性 OUD 治疗政策之间存在关联。尽管对孕产妇和儿童健康有负面影响，但针对患有 OUD 的孕妇的限制性国家法规仍然存在。改变强制性和/或刑事化监​​管并重新定义“家庭友好”可能会改善个人和家庭的结果。尽管对孕产妇和儿童健康有负面影响，但针对患有 OUD 的孕妇的限制性国家法规仍然存在。改变强制性和/或刑事化监​​管并重新定义“家庭友好”可能会改善个人和家庭的结果。尽管对孕产妇和儿童健康有负面影响，但针对患有 OUD 的孕妇的限制性国家法规仍然存在。改变强制性和/或刑事化监​​管并重新定义“家庭友好”可能会改善个人和家庭的结果。