Automatic protocols for perinatal drug testing harm the maternal–child relationship

Urine drug screening (UDS) policies that have been updated, combined with clinical decision support, may reduce racially biased reporting to child protective services (CPS) during prenatal and postnatal care and labor and delivery. The key is to remove isolated cannabis use and limited prenatal care as an automatic order for urine drug screening, according to a recent study. The researchers found that updating the policy was associated with a significant reduction in racial disparities in both urine drug testing and reporting to CPS. Black patients who are pregnant are significantly more likely than White patients to undergo drug testing and reporting to CPS, the researchers noted. For the study, the researchers looked at 9,396 pregnant patients at one midwestern center, about half of whom were Black. The intervention revising the drug testing policy to eliminate the automatic cannabis and limited prenatal care triggers, and to add clinical decision-making.