According to a new investigation from The Marshall Project, hospitals are giving women drugs during labor and then reporting them to child welfare services when they later test positive for those same drugs. These cases are one of the more maddening side effects of an out-of-control drug war combined with strict mandatory reporting laws.
"Hospital drug testing of pregnant women, which began in the 1980s and spread rapidly during the opioid epidemic, was intended in part to help identify babies who might experience withdrawal symptoms and need extra medical care," writes The Marshall Project reporter Shoshana Walter. "Federal law requires hospitals to alert child welfare agencies anytime such babies are born."
The problem is that these pee-in-a-cup tests are frequently inaccurate and vulnerable to false positives. One 2022 study cited by Walter found that 91 percent of women given fentanyl in their epidurals tested positive for it later. Making matters worse, in several cases reviewed by Walter, a simple lack of due diligence played a major role. In these cases, "doctors and social workers did not review patient medications to find the cause of a positive test. In others, providers suspected a medication they prescribed could be the culprit, but reported patients to authorities anyway," Walter writes.
One woman Walter spoke to was reported to child welfare services soon after she gave birth to a stillborn daughter. She had tested positive for benzodiazepine—the same drug she was given before her emergency C-section. Another woman was given morphine to ease her pain during childbirth and was reported to child welfare services after her baby's first bowel movement tested positive for opiates—even though the morphine was noted in her medical records and a drug test she took shortly before she went into labor showed no drugs in her system. After another woman tested positive for meth, her four children—including a newborn—were taken from her and kept in first care for 11 days. They weren't returned until another drug test showed that the positive test was triggered by a heartburn medication she had been given at the hospital.
"Hospitals often lack policies requiring providers to review a patient's records to see what medications they received before reporting them to authorities. Mandatory reporting laws protect doctors from liability for reports made 'in good faith'" even if they turn out to be wrong," Walter writes. "Some hospitals require social workers to automatically file a report for any positive test,"
"In at least 27 states, hospitals are required by law to alert child welfare agencies about a positive test or a potential exposure to the baby," Walter adds. "But not a single state requires hospitals to confirm test results before reporting them."
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