By Crystal Lindell

A California mother wasn’t allowed to take her newborn baby home because she ate a Costco salad with poppy seeds and then tested positive for codeine.

A woman in Philadelphia had her baby taken away by child welfare workers after her prescription ADHD medication resulted in a positive drug test for meth. 

A Pennsylvania woman had her newborn taken away by the state for three months because she tested positive for opioids after eating pasta salad.

These are just some of the stories shared in an alarming investigation by The Marshall Project about hospitals giving urine drug tests to new moms — and then reporting them to child welfare agencies when the tests show false positives. 

The Marshall Project interviewed dozens of patients, medical providers, toxicologists and other experts to report the story. They also collected information on over 50 mothers who faced investigations over positive drug tests that were likely wrong. 

At least 27 states require hospitals to alert child welfare agencies if a mother tests positive for an illicit drug, but no state requires hospitals to confirm the test results before reporting them.

While it's unclear how many of the nation’s 3.6 million births every year involve drug testing, healthcare experts told The Marshall Project that urine screening is ubiquitous and “tens of  thousands of infants are reported annually to authorities for in utero drug exposure, with no guarantee that the underlying tests are accurate.”

Many common foods and medications — from antacids and antidepressants to blood pressure and cold medicines — can prompt false results because urine drug tests are often inaccurate.

“People should be concerned,” Dr. Stephen Patrick, a neonatal researcher told The Marshall Project. “This could happen to any one of us.”

A 2001 article in the BMJ makes it clear that, unfortunately, this is not a new problem. The article focused on a U.S. Supreme Court ruling regarding hospitals drug testing new mothers. In a 6 to 3 decision, the court ruled that hospitals cannot drug test pregnant women without their informed consent or a valid warrant if the purpose is to alert the police to a potential crime.

“While the ultimate goal of the programme may well have been to get the women in question into substance abuse treatment and off drugs, the immediate objective of the searches was to generate evidence for law enforcement purposes in order to reach that goal,” the Court said. “It is especially difficult to argue that the program here was designed simply to save lives.”

Although that ruling came down two decades ago, The Marshall Project found that hospitals have gotten around it by using drug screenings to report patients to child welfare services, instead of the police. 

We should call these child welfare interventions what they are: kidnappings. And like any kidnapping, they can cause long-lasting harm to mothers, children and families. 

A 2022 report from Human Rights Watch and the American Civil Liberties Union focused on children who were unjustly removed from a parent's home, often because of the perception by child welfare workers that poverty leads to neglect. 

"Removing a child from their parents, even for a short time, can be highly traumatizing, with long-term consequences," the report found. "In some cases, children in out-of-home placements experience maltreatment, including sexual or physical abuse, causing further trauma."

The Marshall Project found that false-positive drug tests were impacting mothers of all socioeconomic classes and occupations — from a lawyer to a school librarian to a nurse.

There’s a special type of outrage that comes from knowing that hospitals are taking away newborns based on faulty drug tests. But I would argue that the outrage shouldn’t stop there. 

New mothers who actually misuse drugs should not automatically have their babies stolen by the government either. Someone who takes a stray Norco tablet left over from a relative’s past surgery isn’t automatically a bad parent just because they used a prescription drug that wasn’t their own.

The United States has done such a great job spreading “War on Drugs” propaganda that most people just blindly accept the assertion that drug use unequivocally creates an unsafe environment for a baby. Just looking at our evolving cannabis laws shows that past assertions about “Reefer Madness” were not based on any real evidence. 

‘We’re Going to Be Held Liable for That’

One doctor interviewed by The Marshall Project tried to justify the heinous policy of automatically involving child welfare departments after a mother’s positive drug test. He shared a sentiment that many pain patients have heard from doctors and pharmacists about opioid medication.

“God forbid the baby goes home, withdraws and dies, we’re going to be held liable for that,” Dr. Adi Davidov, an obstetrician at Staten Island University Hospital, which drug tests every birthing mother, told The Marshall Project.

"Liable." The word is so telling. As usual, the hypothetical potential for the doctor to face even minor repercussions is the real worry.  

If treating a newborn for opioid withdrawal was really the concern, that could easily be addressed without any involvement from child welfare departments. 

Of course, these policies are also examples of “do as I say, not as I do.” The Marshall Project found that while mothers often lack legal protection from false positives, “most of the caseworkers who investigate them are entitled to confirmation testing and a review if they test positive for drugs on the job."

Allowing for confirmation testing is the type of policy that’s created when the policymakers are concerned about protecting child welfare workers. When it comes to new mothers though, that empathy dies. 

My hope is that the report from The Marshall Project prompts governments and hospitals to re-evaluate their drug testing policies and stop automatically reporting mothers to child welfare agencies. But after watching the War on Drugs up close for over a decade, I’m not optimistic. 

The most effective tactic the War on Drugs uses is convincing people that its harmful policies won’t hurt them. That only bad people use drugs and good people don’t, so you’ll be safe. We’re only after the bad guys.

But the War on Drugs has never been about helping people. Many pain patients have already learned that lesson the hard way, as doctors refuse to give them the opioid medications they need to function. 

But the war is relentless. It never stops. And it’s always seeking new ways to extend its long, dangerous claws into people's lives in unexpected ways. 

As the saying goes, none of us are safe until all of us are safe. Until we drastically reframe our views and policies regarding drug use, we all remain potential victims of the War on Drugs.