Birthing parents reported that racial bias drove disparities in newborn drug testing, and that the health and legal risks of cannabis use during pregnancy were poorly communicated.
OB-GYNs, hospital policymakers, child welfare professionals, and maternal health equity advocates.
Black birthing people face disproportionate newborn drug testing and CPS reporting compared to white parents
What the researchers found
Four major themes emerged: (1) honesty about substance use with providers could lead to punishment and CPS reporting, (2) historical and contemporary racism contributed to racial disparities in newborn drug testing, (3) cannabis risks during pregnancy were poorly explained by healthcare providers, and (4) participants wanted non-punitive, respectful care with clear explanations of testing and reporting policies.
Why it matters
Black birthing people face disproportionate rates of newborn drug testing, CPS reporting, and termination of parental rights. Understanding patient perspectives on these disparities is essential for policy reform.
The numbers in context
15 participants interviewed. Four major themes identified. Study was the third phase of a mixed methods design with guidance from a 6-member Participatory Council and two external antiracist research consultants.
How the study worked
Qualitative study with semi-structured interviews of 15 participants who gave birth within the past 12 months at a midwestern U.S. academic hospital. Purposeful sampling of racial minorities and those who underwent newborn drug testing. Analysis informed by Public Health Critical Race Praxis.
What this study cannot tell us
Small sample (n=15) from a single hospital. Qualitative design captures perspectives but cannot establish prevalence of experiences. Self-selected participants may not represent all birthing parents.
How to read the evidence
Small qualitative study from a single site provides rich perspective data but cannot establish generalizability.
When this study was published
2025 publication.
The bigger picture
As cannabis legalization expands, the tension between legal adult use and punitive drug testing policies for pregnant people creates a particularly fraught situation, especially for Black parents who already face disproportionate surveillance.
Questions still open
- Would universal newborn drug testing (testing all newborns rather than selective testing) reduce racial disparities?
- How do newborn drug testing policies vary between states with and without legal cannabis?
Read the original research
"Treating me like a criminal": A qualitative study of birthing parents' perspectives on racism and biases in newborn drug testing for substance exposure during pregnancy.
Journal of substance use and addiction treatment, 176, 209745
Citation
Huizinga, Jamie L; Oshman, Lauren; Onishchenko, Regina; Joassaint, Madgean; Madlambayan, Emily; Van Sparrentak, Murphy; McCabe, Katharine; Townsel, Courtney; Frank, Christopher J; Chandanabhumma, P Paul; Wu, Justine P. (2025). "Treating me like a criminal": A qualitative study of birthing parents' perspectives on racism and biases in newborn drug testing for substance exposure during pregnancy.. Journal of substance use and addiction treatment, 176, 209745. https://doi.org/10.1016/j.josat.2025.209745
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