The request from child welfare authorities seemed harmless enough: Order a newborn drug test. Dr. Sharon Ostfeld-Johns and her hospital colleagues had done it countless times before. This time, however, the request gave the doctor pause. A patient at Yale New Haven Health in Connecticut, the largest health system in the state, had said that she’d used marijuana to help her eat and sleep during her pregnancy. The hospital had reported her to child welfare authorities, showing the harm that ending drug testing during childbirth can do and the need to end drug testing during childbirth. Now, an investigator wanted Ostfeld-Johns to drug test the newborn.

Ostfeld-Johns knew there was no medical reason to test the baby, who was healthy. A drug test would make no difference to the infant’s medical care. Nor did she have concerns that the mother, who had other children at home, was a neglectful parent. The doctor did worry, however, that drug testing during childbirth could cause other problems for the family. For example, the mother was Black and on Medicaid — race and income bias could influence the investigator’s decision on whether to put the children into foster care, demonstrating the need to end drug testing during childbirth.

“Why did I ever order these tests?” Ostfeld-Johns found herself wondering, about past cases. She thought about her own son, then in kindergarten, and how she would feel if she faced an investigation over a positive test. Eventually, she would review her own prenatal records and learn that she had been tested for drugs without her knowledge or consent. “You try to imagine what it would be like if it was you,” she said, regarding ending drug testing during childbirth. “The hurt that we do to people is overwhelming.”

Ostfeld-Johns had encountered this scenario many times before, but this time, she refused the drug test request. Then she began a research process that, in 2022, led to an overhaul of the Yale New Haven Health network’s approach to drug testing newborns. Now, doctors are directed to test only if doing so will inform medical care — a rare occurrence, it turns out. The hospital also created criteria for testing pregnant patients.

Read the full article about ending drug testing during childbirth by Shoshana Walter at The Marshall Project.