A comprehensive six-year review of state and federal data has uncovered a deeply concerning trend: tens of thousands of new mothers across the United States have been referred to law enforcement by hospitals and child welfare agencies over allegations of drug use during pregnancy. The report, conducted by The Marshall Project, examined data from 21 states and found that these referrals frequently originated from flawed drug tests that produce false positive results.
Widespread Referrals Based on Unreliable Evidence
The investigation reveals that more than half of the cases referred to law enforcement in 15 states—approximately 22,000 referrals—were ultimately dismissed by child welfare agencies as not involving any actual abuse or neglect. Despite this, police in many jurisdictions pursued criminal investigations based solely on the initial, often inaccurate, test results. The report highlights that urine drug screens are notoriously unreliable and frequently fail to distinguish between illegal substances and legal products like CBD or prescribed medications without confirmatory testing.
Personal Stories of Trauma and Injustice
One particularly distressing case involved Ayanna Harris-Rashid, who gave birth to a baby boy in South Carolina in 2021. Harris-Rashid had used legal CBD gummies and a hemp-based ointment to manage nausea and pain during her pregnancy. After both she and her newborn tested positive for marijuana, hospital staff reported her to child welfare officials, who subsequently forwarded the case to the police.
Harris-Rashid was arrested and spent a night in jail on a felony child neglect charge, which was later dropped. However, the emotional and physical damage was irreversible. The stress of the ordeal caused her milk supply to decrease, ultimately preventing her from breastfeeding her son. "They shook me bare. They made me feel very indecent and inhumane," she recounted. "This is a person, a woman, a mother, an actual individual. What justifies this?"
Systemic Failures and Automatic Reporting Policies
The report documents numerous instances where false positives led to severe consequences. In Oklahoma, sheriff's deputies removed two children from their parents after a hospital drug test incorrectly indicated meth use, a result later attributed to an acid reflux medication. In South Carolina, police questioned a mother who tested positive for fentanyl due to her epidural medication.
Alarmingly, the investigation found that in 13 states, child welfare agencies automatically share all such reports with law enforcement, regardless of the circumstances. Oklahoma exhibited the highest referral rate, with approximately one referral for every 24 births. This automatic reporting mechanism has created a system where new mothers are disproportionately targeted without adequate safeguards.
Legal and Health Implications
Criminal prosecutions of pregnant women have surged in recent years, with a notable increase following the Supreme Court's 2022 Dobbs decision, which overturned Roe v. Wade. This trend is especially pronounced in states with stringent abortion laws, where pregnant individuals face heightened scrutiny and legal vulnerability.
Dana Sussman, senior vice president of the legal advocacy organization Pregnancy Justice, expressed profound concern: "My initial genuine reaction is, frankly, shock and dismay. This represents an incredibly regressive and counterproductive approach. The states that are doing these automatic referrals make the women in those states incredibly vulnerable. It opens the door, even when there's no basis in law, to actually bring these prosecutions."
A Shift Towards More Compassionate Policies
Despite these troubling findings, some states have begun to reassess their policies. Illinois, for example, ended its requirement to notify police in 2024, citing evidence that punitive measures worsen health outcomes for both mothers and babies. This move reflects a growing recognition that supporting maternal health, rather than criminalizing it, leads to better results for families.
The report underscores the urgent need for reform in how drug testing is conducted during pregnancy and how positive results are handled. Ensuring accurate testing protocols and eliminating automatic referrals to law enforcement are critical steps toward protecting the rights and well-being of new mothers and their children.
