Why use this fact sheet?
As medical professionals who work with pregnant patients, you face numerous medical, legal, and ethical decision points when treating a patient for substance use during pregnancy, and when providing care to a neonate with drug or alcohol exposure. Sometimes, the legal requirements for reporting substance use or exposure are unclear, or may be the opposite of medical best practice. Moreover, patient privacy dictates careful attention to the law to avoid unnecessary reports that may lead to HIPAA violations. This resource provides a brief summary of reporting requirements by state for prenatal drug use and substance-exposed newborns and provides explanations of the wording used in these requirements. This resource does not provide legal or medical advice but is intended to help you differentiate what is legally required from what is merely state agency guidance. Importantly, only two states require drug testing of pregnant and birthing patients in certain circumstances, and only four states mandate drug testing of newborns in certain circumstances.
Your hospital, clinic, or practice may have additional reporting requirements that you should be familiar with. Providers can protect the therapeutic relationship and help patients maintain agency and confidentiality by:
- Not reporting patients if not legally required
- Informing patients of what the provider may have to report prior to testing/treating the patient or neonate
- Obtaining informed and documented consent around parental and neonatal drug testing
- Documenting the medical reason for a drug test in the patient’s chart
- Carefully considering what information is necessary to document in a medical chart
Providers can also help protect their patients from unjust criminalization by ensuring that their hospital or clinic reporting policies do not conflict with state laws on medical privacy. If you have any additional questions about state reporting requirements, please contact If/When/How for technical assistance at tinyurl.com/IWHTechnicalAssistance. For continuing education on the updated science and laws around prenatal substance use, as well as the opportunity to hear from directly impacted parents, check out the Doing Right at Birth webinar series.