States That Drug Test Newborns 2021

Giving a newborn a drug test might seem like it’s a strange process to perform, but there is a reason for it.

Identification of newborns exposed to illicit substances can alert the practitioner to problems one might encounter in the delivery room and nursery, such as intoxication, withdrawal syndromes, and long-term needs for exposed neonates. It can also serve as an opportunity to identify families with substance abuse disorders, which can put the newborn at risk after being discharged from the hospital.

According to a report from the U.S. National Institutes of Health, self-reports of illicit drug use are often inaccurate and universal drug testing is neither practical for the clinician nor recommended by the American Academy of Pediatrics](https://www.aap.org/en-us/Pages/Default.aspx). It is recommended, however, that every facility that provides newborn care establish their own testing protocols, including establishing unbiased guidelines to identify those who should be tested.

Two modes of testing are available: umbilical cord tissue and meconium. Meconium is the earliest stool of an infant composed of materials ingested while the infant is still in the uterus. Meconium the traditional specimen to detect and document drug use during pregnancy, while umbilical cord tissue is relatively new for testing.

Effects of Maternal Drug Use

Exposure to maternal drug use during pregnancy may lead to adverse effects such as poor neonatal development and acute adverse effects such as infant mortality and neonatal abstinence syndrome (NAS).

NAS is a group of conditions caused when a baby is exposed to certain drugs in the womb, most often opioids, and is withdrawn from those drugs after birth. NAS can lead to long-term health and developmental problems such as hearing and vision problems and issues with learning and behavior. Most babies with NAS get treatment in the hospital after birth and typically get better within a few days or weeks.

Universal vs. Risk-Based Testing

There are advantages and disadvantages to both universal and risk-based testing. Universal testing will generate more positive results that require follow-up by the laboratories and patient care teams, as well as may increase referrals to social services and play an increased burden on governmental agencies for relatively low-risk mothers.

Risk-based testing uses hospital-defined criteria such as maternal history or signs of drug use, social risk factors, limited or absent prenatal care, and symptoms of withdrawal. This testing approach, however, may be perceived as unfairly profiling mothers, exposing the institution to legal issues. Risk-based testing may also miss infants exposed to drugs if the policies do not adequately identify and test for probable exposures.

Drug Testing for Newborn Exposure by State

States handle drug use during pregnancy differently.

Tennessee is the only state with a statute that specifically makes it a crime to use drugs while pregnant. Alabama and South Carolina have interpreted existing child endangerment and chemical endangerment statues to all prosecution of drug-using pregnant women.

Eighteen states have laws that say drug use during pregnancy is child abuse. Additionally, in three states, Minnesota, South Dakota, and Wisconsin, women who use drugs during pregnancy can be involuntarily committed to a treatment program. In fifteen states, health care workers are required to report to authorities if they suspect a woman is abusing drugs during pregnancy. In most states, there is no law that requires hospitals to test infants and new moms for illicit substances. In Minnesota and North Dakota, a test is required if drug-related complications occur at birth.

The following four states require testing if drug use during pregnancy is suspected (risk-based testing):

States That Drug Test Newborns 2021

State Newborn Drug Testing 2021 Pop.
AlabamaSubstance Use During Pregnancy is a Crime Substance Use During Pregnancy is Child Abuse4,934,193
AlaskaHealth Care Workers Must Report Drug Abuse During Pregnancy724,357
ArizonaHealth Care Workers Must Report Drug Abuse During Pregnancy7,520,103
ArkansasSubstance Use During Pregnancy is Child Abuse3,033,946
CaliforniaNo specific laws39,613,493
ColoradoSubstance Use During Pregnancy is Child Abuse5,893,634
ConnecticutNo specific laws3,552,821
DelawareNo specific laws990,334
FloridaSubstance Use During Pregnancy is Child Abuse21,944,577
GeorgiaNo specific laws10,830,007
HawaiiNo specific laws1,406,430
IdahoNo specific laws1,860,123
IllinoisSubstance Use During Pregnancy is Child Abuse Health Care Workers Must Report Drug Abuse During Pregnancy12,569,321
IndianaSubstance Use During Pregnancy is Child Abuse6,805,663
IowaRisk-Based Testing Substance Use During Pregnancy is Child Abuse Health Care Workers Must Report Drug Abuse During Pregnancy3,167,974
KansasNo specific laws2,917,224
KentuckyRisk-Based Testing4,480,713
LouisianaSubstance Use During Pregnancy is Child Abuse Health Care Workers Must Report Drug Abuse During Pregnancy4,627,002
MaineNo specific laws1,354,522
MarylandHealth Care Workers Must Report Drug Abuse During Pregnancy6,065,436
MassachusettsHealth Care Workers Must Report Drug Abuse During Pregnancy6,912,239
MichiganNo specific laws9,992,427
MinnesotaRisk-Based Testing Substance Use During Pregnancy is Child Abuse Substance Abuse During Pregnancy is Grounds for Civil Commitment Health Care Workers Must Report Drug Abuse During Pregnancy5,706,398
MississippiNo specific laws2,966,407
MissouriNo specific laws6,169,038
MontanaHealth Care Workers Must Report Drug Abuse During Pregnancy1,085,004
NebraskaNo specific laws1,951,996
NevadaSubstance Use During Pregnancy is Child Abuse3,185,786
New HampshireNo specific laws1,372,203
New JerseyNo specific laws8,874,520
New MexicoNo specific laws2,105,005
New YorkNo specific laws19,299,981
North CarolinaNo specific laws10,701,022
North DakotaRisk-Based Testing Health Care Workers Must Report Drug Abuse During Pregnancy770,026
OhioNo specific laws11,714,618
OklahomaSubstance Use During Pregnancy is Child Abuse Health Care Workers Must Report Drug Abuse During Pregnancy3,990,443
OregonNo specific laws4,289,439
PennsylvaniaNo specific laws12,804,123
Rhode IslandSubstance Use During Pregnancy is Child Abuse Health Care Workers Must Report Drug Abuse During Pregnancy1,061,509
South CarolinaSubstance Use During Pregnancy is a Crime Substance Use During Pregnancy is Child Abuse5,277,830
South DakotaSubstance Use During Pregnancy is Child Abuse Substance Abuse During Pregnancy is Grounds for Civil Commitment896,581
TennesseeSubstance Use During Pregnancy is a Crime Substance Use During Pregnancy is Child Abuse6,944,260
TexasSubstance Use During Pregnancy is Child Abuse29,730,311
UtahHealth Care Workers Must Report Drug Abuse During Pregnancy3,310,774
VermontNo specific laws623,251
VirginiaSubstance Use During Pregnancy is Child Abuse Health Care Workers Must Report Drug Abuse During Pregnancy8,603,985
WashingtonNo specific laws7,796,941
West VirginiaNo specific laws1,767,859
WisconsinSubstance Use During Pregnancy is Child Abuse Substance Abuse During Pregnancy is Grounds for Civil Commitment5,852,490
WyomingNo specific laws581,075

States That Drug Test Newborns 2021