Outrage as hospitals test pregnant moms for drugs near low-income neighborhoods

[el_em_en_oh]

Expecting moms in New York are being drug tested in hospitals near low income neighborhoods.  But pregnancy advocates are calling the practice racist and discriminatory.

“You cannot tell from a drug test if someone is fit to parent,” said Lynn Paltrow of the National Advocates for Pregnant Women.

More than a dozen pregnancy wards across the city administer a marijuana test, without the mother’s consent.  According to the Daily News, the number of tests given to pregnant women varies from hospital to hospital.  St. Barnabas Hospital in the South Bronx requires all mothers to agree to testing.  If they refuse, the babies are tested.

But Lenox Hill Hospital on the ritzy Upper East Side only tests if a mother is clearly under the influence.

If a mother fails the pot test, the results are sent to child-protection services.  In one case, a Bronx mother smoked a joint at a party during her pregnancy and failed.  The Administration for Child Services ordered her to ‘Mommy Probation’ until they agency dropped the case earlier this year.

Hospitals that do random drug testing say their first priority is the child’s health.  An argument Paltrow does not support.  She says scientists believe marijuana poses less risk to the fetus than alcohol or cigarettes.  Yet turning over results to the government can destroy a family.

“Low income families expect privacy.  Yet, they have less of a guarantee than job applicants do,” said Paltrow.

We reached out to the ACS to see how many neglect cases stem from failed pregnancy ward drug tests.  The agency did not have an accurate number.

SOURCE: http://pix11.com/2012/12/26/pregnant-women-in-low-income-areas-more-likely-to-be-drug-tested/?hpt=us_bn7

[adgal]

It always has to come down to benefit vs. risk.  And Barb, your daughter in laws situation is a perfect example of the happy outcome when a situation is monitored and the baby given the care she needs at birth.  Even for folks who are abusing vs. using for medical treatment it can and often does have a good outcome for the child when the situation is handled properly.  I'm glad to hear all is well.  She sure is gorgeous, no question about that!!

[nursegirl6572]

I'm a lot older than most of you, but I smoked during both of my pregnancies, because when I  mentioned quitting to my OB, he told me NOT to even consider trying it while I was pregnant.  That was back in the day when nearly everyone smoked, including the OB, as well as most doctors.


I know...how crazy is it how different the standards and recommendations have become?


but there was still a withdrawal for the baby, which wasn't pretty, but she's a beautiful, spoiled rotten 2 yr old, now who is none the worse for wear.

It's always unfortunate to have that kind of situation, but it sounds like your daughter had very good doctors.  Glad to hear the baby is doing well (and spoiled..lol)

[Barb135]

Sorry to be late for the party, but you know how it goes, sometimes........

"While it's hardly a comparison, I quit smoking during my pregnancies.  It wasn't easy...but it was a no brainer for me.  It just wasn't an option.  I'm not using that example as a judgement...but why can some do it and not others?"

I'm a lot older than most of you, but I smoked during both of my pregnancies, because when I  mentioned quitting to my OB, he told me NOT to even consider trying it while I was pregnant.  That was back in the day when nearly everyone smoked, including the OB, as well as most doctors.

As far as being drug tested at delivery - they should be, but I agree with adgal that they should be tested early in the pregnancy.  My daughter has lupus and her treatment includes some pretty rough drugs.  Of course her OB and rheumy worked together to make sure there was minimal effect on the fetus, but as would be expected, the baby was born, with addictions to these drugs.  Fortunately, they were able to taper my daughter's med some prior to delivery, but there was still a withdrawal for the baby, which wasn't pretty, but she's a beautiful, spoiled rotten 2 yr old, now who is none the worse for wear.

[specialmom]

Oh, adgal, HIV testing is routine here.  I'm sorry.  Yes, even I, an OLD married lady was tested routinely in my first trimester for HIV.  

[orphanedhawk]

If we met, I think we'd find we have more in common than just home births and beating hep C :)

[adgal]

I agree SM.  If you remove the automatic removal threat (or even the perceived threat as it's not always automatic removal), you would see a lot more women take treatment.  It really is incredible how pregnancy is a motivator for so many to change their lives.  But we know that doing it on your own usually doesn't work - they need help.

I'm surprised to hear HIV isn't tested for.  Here it's routine as part of your first prenatal blood screen.  All sexually transmitted diseases are actually.  I guess you could opt out if you wanted to, or choose not to seek prenatal care, but I know it was on my labs request automatically.

[nursegirl6572]

SM, as always, you articulate things so well.  

And it might put a mom into the system to keep an eye on.  (someone having issues staying clean while pregnant would be good to have on the radar once the baby is born.).  

Well put.

[specialmom]

I would like to see this done for all women as part of the routine procedures pregnant ladies go through.  Then it wouldn't be a big deal, we'd all go through it.  I don't think it would be a huge percentage of women that would then dey themselves/their babies prenatal care because so many uneducated (hate to put it that way . . . ) women already believe they are tested.  

I don't think it should mean that someone automatically should have their children removed.  It's an opportunity for education.  and it is a chance to identify big problems.  And it might put a mom into the system to keep an eye on.  (someone having issues staying clean while pregnant would be good to have on the radar once the baby is born.).  

So, I'm all for it.  

[nursegirl6572]

Problem is, how many people will simply opt out of pre natal care, thereby endangering the child even more if they think it will be turned over to cps.

True.  So frustrating....when you find somewhat of a solution, there's always the downside.  :0(

I also think HIV should be tested for as well. .
I totally agree.  While MOST pregnant Moms comply with the HIV testing that is recommended, still many refuse.  I also am not a fan of making things mandatory...but I would be okay with both of the above.

[R Glass]

  "I am so glad I had a home birth ! "
All 3 of mine were born at home to. Do you realize, after all these years we have found something we have in common? Maybe it's a sign of "The End Times" LOL

[teko]

When I had my children, there were always things to be tested for. Adding one for drug abuse should be automatic imo. Problem is, how many people will simply opt out of pre natal care, thereby endangering the child even more if they think it will be turned over to cps. I also think HIV should be tested for as well.

[adgal]

If interested, here is an interesting article on the whole addiction as nature debate....I think it's well rounded personally.

http://www.ibdna.com/regions/UK/EN/?page=genesAndAddiction

Another interesting study...

http://www.substanceabusepolicy.com/content/5/1/19

[adgal]

but if they're going to do testing it should be across the board and not just in poor or non-white neighborhoods.

And there in lies the problem.  We know for absolute certain that a women who seeks care in our clinic is always always red flagged for testing at delivery.  It seems that no matter that we KNOW that addiction crosses all socio economic lines (and in fairly equal numbers I might add), those who are low income, on welfare, etc. seem to be targeted. They are also significantly more likely to have a full scale investigation done should there be a complaint over their wealthier conterparts.  And that is where I have an issue.  I would be ok if everyone was tested (although again, it would make more sense to me to be tested early in pregnancy before the harm is really done) or if there is an indicator.  But financial resources are not an indicator of addiction, and I don't know why the authorities so often think that is the case.  Research study after study proves that not to be the case.  It confounds me.

Nursegirl, I wish we knew why some can give it up and others cannot.  Just as some can have a few drinks and walk away and others can't stop once they've started.  Some people just are more prone to addiction.

Some interesting new research into addiction (I'll see if I can find a link or copy of the study) that our head OB nurse told me.  DNA testing has turned up a link to FASD.  So, two women can drink the same amount of alcohol at the same time during their pregnancy and one have an FASD baby and the other not.  So it seems there is a genetic component to all this.  Some believe that this also will prove their is a genetic link to addiction.  Not sure how exactly as I am no scientist, but it is interesting stuff.  I know some believe addiction to be a genetic disease (that is my pesonal belief) and others believe it has more to do with lifestyle choices, etc.  It would be nice to have evidence proving this one way or the other - maybe we could actually begin working to solving the problem as it does destroy lives.  No question there.

[orphanedhawk]

I am so glad I had a home birth !
Not that these issues were even mentioned back in the good old days.
I smoked a little pot for my morning sickness. Just a puff and not for long. I think it's better than a lot of the chemical pharmaceutical drugs they give women.
My kids had no birth defects, no problems.

I don't like the idea of any mandatory testing for anything, but if they're going to do testing it should be across the board and not just in poor or non-white neighborhoods.

[nursegirl6572]

Good idea, Amanda.  Absolutely.

It IS very sad.  I have had several people close to me VERY deeply tangled in addiction...GOOD people, people with a lot to lose, smart people, caring people.  It's amazing what an addict will sacrifice, and the lines they will cross in the name of addiction.  Certainly, exposing an unborn child to dangerous or addictive drugs is on top of that list (IMO anyway).

I DO have a lot of compassion...but at the same time, it's HARD not to scratch my head.  While it's hardly a comparison, I quit smoking during my pregnancies.  It wasn't easy...but it was a no brainer for me.  It just wasn't an option.  I'm not using that example as a judgement...but why can some do it and not others?  Million dollar question I suppose.  I also always drank my 2 "doctor approved" cups of regular coffee a day...I knew people who thought that was terrible.  It's all relative.

I just wish these women would try to really reach out for help more.  I know the fear of being in trouble, or losing their child is a big deterrant.  That's why your idea is a good one.

Very very sad for all involved.

[adgal]

I would even take it a step further and say test early in the pregnancy.  And my preference would be to offer treatment.  I think more women would come forward for help if not so terrified of the authorities.  For me, this is yet another reason to decriminalize drug usage.  Again, not to encourage use, but to remove fear of admitting usage if help is desired.  I can't help but think this might go a long way in helping to solve the drug abuse issue.  Just basing this on women I talk to and what they tell me.  It's so sad.

[nursegirl6572]

My daughter in law, went to the clinic to get meth while pregnant. Said withdrawal would harm the baby more than the meth would.

That's true...w/d can definitely be very risky.  Someone obviously on maintenence methadone or subutex would be on it through a doctor, with the OB aware of the medication.  In those cases, usually no action is taken, along the lines of CYS that is.

Education is definitely important...if a pregnant woman has a drug problem, the very best thing she could do is be honest and upfront with her OB...so they can determine the best course of action.  Obviously, if a woman tests + at the time of delivery, and the OB has NO knowledge of the abuse, then the woman was not honest...therefore measures would have to be taken to protect the baby by investigating further.

In the SA forum, when pregnant women post a question, the advice is always to contact their OB ASAP, but NOT to stop taking the drugs (in respect to opiates).

I still think an accross the board, universal drug test at delivery for all women/babies would be an awesome idea.  Not only would children be better protected, but maybe more women could get help.

[MrsPincince]

It should be a mandatory test for ALL women..Not just lower income.....

[adgal]

It is actually often considered extremely harmful to withdraw during pregnacy. I could share all kinds of horror stories about it, particularly when women do it on their own.

Any attempt to withdraw during pregnancy should only EVER be done under medical supervision.  And methadone is often used during pregnancy and is considered the lesser of two evils.  I mentioned that our agency has a Women's Health Clinic.  This is staffed by OB's and OB nurses and while we cater to all low income women, it's primarily a supportive, non judgemental clinic for pregnant low income women. However, we do all the methadone in our city for pregnant women, regardless of income level.  And there are a lot of them.  There are actually very few treatment clinics that will withdraw pregnant women as it's quite tricky.

[teko]

My daughter in law, went to the clinic to get meth while pregnant. Said withdrawal would harm the baby more than the meth would. So how contradictory is that compared to this article? In fact she did it with two pregnancies.

[nursegirl6572]

Smoking a joint is hardly the same as being on crack cocaine.

I agree, to a point.  While the act itself may not be as harmful to the fetus, it shows lack of good judgement and blatant disregard for the safety of the fetus.  A poitive result should initiate an investigation.  Investigations can yield many different outcomes.  I definitely feel strongly about there being a fair system in place that dooes TWO things in an investigation...ensures a child is not at risk, and works toward a universal goal of the child remaining at home.  Removal from the home should not be taken lightly.

And I can tell you that removing a child from their parents should never be automatic.  
I agree!

A child should have to be in danger of neglect or abuse and using drugs doesn't make that so.
I think the act of using drugs while pregnant is abusive, and warrants further investigation.

I tend to agree..though it must include the wealthy moms too
Totally agree...testing should be universal.

It IS somewehat hypocritical to go after women who abuse drugs, and not alcohol or tobacco.  All of those substances can be harmful...because some are legal shouldn't make a difference.  That's a shame.  It's hard to draw those lines though, I suppose...as women are potentially going to make all kinds of poor decisions while pregnant that could harm her baby.  You cannot police pregnant women.

[adgal]

I should add though...my son was drug tested at birth.  I wasn't asked for consent, but was informed.  I have never used drugs (except tried pot about a gazillion years ago), so I wasn't worried, but it was a bit of a nervewracking experience.  Just uncomfortable.  But, they did it because he was low birth weight and they aren't sure what happened (my placenta stopped functioning).  That is one of the things that can happen with drug use during pregnancy.  I understood why they did it, but it was intimidating.

[adgal]

I couldn't agree with you more.  Truth be told, although it's all horrible, babies born addicted to drugs (even drugs like crack, etc.) tend to do better long term then those born on the FASD Spectrum.  FASD is brain damage, and it's forever.  While there are intereventions that can be done, there is nothing that can repair the damage.  Drug addicted babies have a better chance once properly withdrawn and under proper care.

As always though, I don't feel laws are the answer with issues like this.  Increased level of education (you would be amazed at how many intelligent, middle and upper class women think it's perfectly fine to drink during pregnancy) and easier access to help are.  Women who are addicted and find themselves pregnant often want to get help - the pregnancy can be a huge motivator - yet are absolutely terrified to seek it for fear of losing their child.  So they will attemp to self wean, and that is downright dangerous in a pregnancy.  

And unfortuantely (again, at least where I live), low income are far more likely to be both tested and have their children removed then the wealthy.  It's just the way it is.

[rivll]

And I can tell you that removing a child from their parents should never be automatic.  A child should have to be in danger of neglect or abuse and using drugs doesn't make that so.

Glad to hear it..There are enough kids in foster care without adding more who could be from relatively good homes. Smoking a joint is hardly the same as being on crack cocaine.
Alcohol is legal but that fetus is drinking when mom drinks so it seems to me if they are going to be testing for drugs they ought to include alcohol and prescription drugs that are being misused.