War on Drugs

The War on Drugs Has Come to the Maternity Ward

Doctors are drug testing pregnant women without their consent, then handing their results over to the state.

Tosin Akintola | 8.11.2026 4:35 PM

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(Photo: AndreyPopov/Newscom)

At first glance, a new mother taking part in a drug screening seems reasonable. For the sake of the mother and child, a doctor performs a clinical test to rule out any complications or signs of risks to the newborn.

But the story quickly takes a dark turn. If there's a positive test result, it doesn't stay between the doctor and the patient. In 24 states and Washington, D.C., a positive test alone is enough to initiate a child welfare report, according to a report by the Legislative Analysis and Public Policy Association. Depending on the state, that test could land the mother on a child abuse registry. Worse still, the mother may be notified the test has occurred only after the fact.

This seems to run afoul of the Supreme Court's ruling in Ferguson v. City of Charleston (2001), where the Court found it unconstitutional to drug test pregnant women without consent solely for "law enforcement purposes." 

However, Enrima Ukoha, an obstetrician-gynecologist and maternal-fetal medicine specialist at the Mount Sinai Hospital in New York, tells Reason this practice—known as "test and report"—is "common"........

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