The Problem: Test-and-Report
Healthcare providers are drug testing and screening perinatal people and their newborns without informed consent and reporting the results to family policing agencies. This practice, commonly referred to as “test-and-report,” violates bodily autonomy, exposes families to the violence of forced family separation, and almost never leads to any connection to care or treatment.
Test-and-report harms newborns, parents, and families by:
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Test-and-report breaks the trust and confidentiality that are essential to good healthcare, and deters pregnant people from seeking necessary prenatal care. For this reason, several medical professional organizations have taken a firm stance against non-consensual drug testing and punitive responses to prenatal substance use.
Prenatal care is critical! According to the U.S. Department of Health and Human Services’ Office of Women’s Health, newborns whose parents do not receive prenatal care are three times more likely to have a low birth weight and five times more likely to die than newborns whose parents do get care.
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Numerous studies and our collective experience show that the best medicine for a newborn is their birthing parent. If a newborn is experiencing Neonatal Abstinence Syndrome (NAS), the growing recommended treatment approach is “Eat, Sleep, Console”—which requires close contact with the birthing parent.
When the family police separate a newborn from their birthing parent, they prevent a newborn from receiving this vital care.
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Test-and-report routinely leads to the forced separation of a newborn from their birthing parent during a time of critical bonding. This practice contributes to children under the age of one accounting for the highest proportion of all children in the foster system.
Family separation and experience in the foster system can lead to severe, long-term health consequences for infants and children, such as post-traumatic stress disorder, low self-esteem, suicidal ideations, and disruptions to psychological and identity development.
What else do you need to know about test-and-report?
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Drug testing is generally not needed to provide optimal clinical care. Worse yet, punitive practices like test-and-report actually make infants less safe.
Ultimately, the symptoms associated with NAS are treatable and often do not require a drug test to resolve. One study found that states’ punitive responses to substance use during pregnancy are associated with higher rates of NAS.
To the extent that a newborn drug test is medically necessary, this bill allows providers to do so after explaining and documenting the medical reason and obtaining written and verbal informed consent from the newborn’s parent.
Test-and-report does not facilitate medical support for the parent either.
Studies show that when healthcare providers conduct a drug test or verbal screen, they rarely follow up about medical treatment. A positive drug test rarely leads to any changes in the course of a person’s care.
On the contrary, people are more likely to be led successfully to treatment by a healthcare provider whom they trust; attempts to force people into treatment generally do not yield positive results.
Importantly, substance use is not inherently incompatible with being able to care for one’s child. Not all parents who use substances have a substance use disorder and many parents who use substances neither need nor want support to address their substance use.
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Federal law (CAPTA/CARA) does not require the drug testing of pregnant and parenting people, nor does it require the reporting of positive test results to family policing agencies. Likewise, New York State has wisely rejected the notion that a positive drug test or evidence of parental substance use alone is synonymous with child maltreatment.
Read more about what CAPTA does and does not require here.
Read more about the history of CAPTA here.
Reports
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Drug Tests Are Not Parenting Tests: The Fight to Reimagine Support for Pregnant People Who Use Drugs
Movement for Family Power, Informed Consent Coalition, & Partners.
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"Whatever They Do, I'm Her Comfort, I'm Her Protector." How the Foster System Has Become Ground Zero for the U.S. Drug War
Movement for Family Power, Drug Policy Alliance, & New York University Family Defense Clinic
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Racial Coercion and Control Over Reproductive Decision-Making and Families
Elephant Circle, Pregnancy Justice, Movement for Family Power, and more.
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The Rise of Pregnancy Criminalization
Pregnancy Justice
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Harming Fathers: How the Family Court System Forces Men to Regulate Pregnancy
Pregnancy Justice
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Parenting and Drug Use
Pregnancy Justice
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Drug Use and Human Milk: Legal and Child Welfare Considerations
Elephant Circle
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Beyond Do No Harm Principles Guide
Interrupting Criminalization
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The War on Drugs Meets Child Welfare
Drug Policy Alliance