National Institute on Aging

Study Finds a Huge Racial Disparity in Newborn Drug Testing

A new study led by researchers at the University of Michigan finds that clinicians ordered drug tests to be performed on Black newborns at nearly four times the rate of other children. Thirty-seven states and the District of Columbia mandate reporting newborns with suspected prenatal substance exposure to the state, and punitive policies that link prenatal substance exposure to newborn drug testing (NDT) may lead to disproportionate reporting of Black parents to Child Protective Services. In some states, such as Oklahoma and Alabama, mothers have been arrested and criminally prosecuted for the use of cannabis during their pregnancy. In total, 24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes.

Researchers examined records of more than 21,000 mothers who gave birth at a large academic medical center from 2014 to 2020. They found that 7.3 percent of babies born to Black mothers received newborn drug testing compared to 1.7 percent of babies born to White mothers.

Racial differences in newborn drug testing remained consistent after the enactment of recreational cannabis legalization in 2018. Newborn drug tests were more likely to be positive for THC after the passage of recreational cannabis laws but the racial disparity in testing remained the same.

“This study finds racial disparities in newborn drug testing unrelated to obstetrical risk,” the authors concluded. “Our findings strongly suggest that changes in policies regarding drug testing and reporting at the hospital and state level and improvement measures focused on the health, well-being, and dignity of Black birthing people are needed to reduce health inequity for Black parents and their newborns.”

The full study, “Incidence of Newborn Drug Testing and Variations by Birthing Parent Race and Ethnicity Before and After Recreational Cannabis Legalization,” was published on the JAMA Open Network. It may be downloaded here.



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