Legal responses to women’s drug use during reproductive years: Implications for reproductive health and access to care

Abstract

This study examines how the criminalization of women’s drug use during their reproductive years affects their access to reproductive healthcare, legal treatment, and psychosocial wellbeing. Using a qualitative research design, the study employed semi-structured interviews with women affected by drug-related criminalization, healthcare providers, legal professionals, and policy-related stakeholders in Beijing, Shanghai, and Guangzhou, China. The findings reveal that criminalization functions as a major barrier to timely healthcare access by generating fear, stigma, and mistrust of formal institutions. Women reported avoiding prenatal and reproductive health services due to concerns about legal consequences, social judgment, and possible loss of child custody. The study also found that punitive responses intensify emotional distress, social isolation, and institutional exclusion, while creating ethical and professional challenges for healthcare providers. These findings suggest that treating women’s drug use primarily as a criminal issue may worsen reproductive health risks rather than reduce them. The study concludes that more effective responses require a shift toward health-centered, rights-based, and non-punitive approaches that prioritize treatment, confidentiality, psychosocial support, and coordinated care. Such reforms are essential for improving maternal wellbeing, protecting reproductive rights, and reducing the harmful effects of stigma and criminalization.