Over 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy. The use of drugs during pregnancy is increasing. In general, drugs should not be used during pregnancy unless necessary because many can harm the fetus.
Drug testing during pregnancy is a controversial topic. The American College of Obstetricians and Gynecologists (ACOG) recommends universal screening to be carried out at the first prenatal visit. However, given the risks associated with full disclosure, it should not be surprising that women may not give honest answers regarding their uses of drugs while pregnant. While urine or blood toxicology screening may be helpful for confirming use of illicit drugs in this setting, non-consensual drug testing of mothers has been deemed unconstitutional by the U.S. Supreme Court. ACOG states, “Urine drug testing has also been used to detect or confirm suspected substance use, but should be performed only with the patient’s consent and in compliance with state laws.” However, newborn infants may be tested without the mother’s consent. The United States Supreme Court has ruled that hospital workers cannot test pregnant women for use of illegal drugs without their informed consent or a valid warrant if the purpose is to alert the police to a potential crime.
Research shows that use of tobacco, alcohol, or illicit drugs or misuse of prescription drugs by pregnant women can have severe health consequences for infants. This is because many substances pass easily through the placenta, so substances that a pregnant woman takes also reach the fetus. Recent research shows that smoking tobacco or marijuana, taking prescription pain relievers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth. Estimates suggest that about 5 percent of pregnant women use one or more addictive substances.
Regular use of some drugs can cause neonatal abstinence syndrome (NAS), in which the baby goes through withdrawal upon birth. Most research in this area has focused on the effects of opioids (prescription pain relievers or heroin). However, data has shown that use of alcohol, barbiturates, benzodiazepines, and caffeine during pregnancy may also cause the infant to show withdrawal symptoms at birth. The type and severity of an infant’s withdrawal symptoms depend on the drug(s) used, how long and how often the birth mother used, how her body breaks the drug down, and whether the infant was born full term or prematurely.
What happens if you fail a drug test while pregnant?
Many states have recently decriminalized the use of marijuana, and more women are using marijuana during pregnancy. How hospitals and health care providers respond to mothers who use cannabis during pregnancy varies. Since the late 1980s, policymakers in the United states have debated the question of how society should deal with the problem of women’s substance use during pregnancy. Prosecutors have attempted to rely on a host of criminal laws already on the books to attack prenatal substance use. The Supreme Courts in Alabama and South Carolina have upheld convictions ruling that a woman’s substance use in pregnancy constitutes criminal child abuse.
Meanwhile, several states have expanded their civil child-welfare requirements to include prenatal substance use, so that prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect. Further, some states, under the rubric of protecting the fetus, authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant women who use drugs; these policies sometimes also apply to alcohol use or other behaviors. A number of states require health care professionals to report or test for prenatal drug exposure, which can be used as evidence in child-welfare proceedings. And in order to receive federal child abuse prevention funds, states must require health care providers to notify child protective services when the provider cares for an infant affected by illegal substance use. Finally, a number of states have placed a priority on making drug treatment more readily available to pregnant women, which is bolstered by federal funds that require pregnant women receive priority access to programs.
Highlights of the Situation in the United states
23 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes, and 3 consider it grounds for civil commitment.
25 states and the District of Columbia require health care professionals to report suspected prenatal drug use, and 8 states require them to test for prenatal drug exposure if they suspect drug use.
19 states have either created or funded drug treatment programs specifically targeted to pregnant women, and 17 states and the District of Columbia provide pregnant women with priority access to state-funded drug treatment programs.
10 states prohibit publicly funded drug treatment programs from discriminating against pregnant women. Also See: What Happens If I You Fail A Drug Test