Explainer: It’s Time to End Test and Report Practices

End harmful “test and report” practices that target pregnant people, fuel family separation, and deepen inequities.

OVERVIEW

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Hospitals and medical care providers across the United States test pregnant and birthing people and newborns for drugs then report results to the family regulation system (also known as child protection system). It’s a harmful practice that hurts Black, Indigenous, and Latine families the most.

Keep reading to learn why this matters for reproductive health, rights and justice and what we want to do about it.

What’s Happening

Hospitals and medical care providers test pregnant and birthing people and newborns for drugs, usually with out even asking them. Then they report positive results to the family regulation system.

Who’s Affected

Medical care providers test Black, Indigenous, and Latine patients are more often, and report them to the family regulation system more often, even though drug use is similar across all people.

The Consequences

Families face stressful investigations by the family regulation system and may even be separated right after birth. This is violence!

This practice began during the “war on drugs” in the 1980s. It wasn’t based on medical evidence and still harms families today.

Drug Testing Rarely Helps, Often Harms

  • Not Needed Medically: Most pregnant and birthing people and newborns don’t need drug testing to get good healthcare, including those exposed to substances. Open, caring talks between patients and providers they trust work better.
  • Often Wrong: The drug tests used often show false results. These tests can’t tell the difference between prescribed medicines, over-the-counter drugs, and illegal substances. Yet healthcare providers use them all the time!
  • A Drug Test Is Not A Parenting Test: A positive drug test tells nothing about how well someone can parent, how much they care for their child, or how deeply they love their family.

Test and Report Is Racist

This is racism in healthcare and the racism gets even worse in the family regulation system.

1.5x
Black pregnant people are at least 1.5x more likely to be drug tested
4-10x
Black newborns are reported to family regulation systems 4-10 times more often than white newborns
0%
Research shows a 0% difference in use rates across racial demographics.

The Devastating Impact on Families

  • Hospital Holds: Parents can’t take their babies home after a positive test
  • Family Separation: Babies and parents are kept apart during critical bonding time. This is way worse for babies than substance exposure!
  • Lasting Harm: More risk of post partum depression and maternal mortality

This separation goes against what’s best for babies exposed to substances, which is skin-to-skin contact and time with parents.

Breaking Trust with Healthcare

  • Avoiding Healthcare During Pregnancy: When pregnant people fear being watched and losing their children, they often skip important healthcare before and after birth.
  • Taking Away Choices: Testing without permission treats pregnant people like they are dangers to their babies, when in fact they are the best thing for their babies. And it takes away their right to make choices about their bodies.
  • Breaking Trust with Doctors: When hospitals become places that report on patients, the trust needed for good healthcare falls apart.

Leading medical organizations are against drug testing without permission and punishing people for substance use during pregnancy.

Physicians for Reproductive Health Supports

  • Asking permission before drug testing: Healthcare providers must get oral and written consent before drug testing pregnant and birthing people or their newborns.
  • Ending medically unnecessary drug testing: It’s time to end the vast majority of drug testing.
  • Ending reporting positive results to the family regulation system: Healthcare providers sending families into systems of surveillance and separation goes against the core of what we are supposed to do

What You Can Do