Addressing Harmful Newborn Drug Testing and Family Separation in U.S. Hospitals

Routine Newborn Drug Testing and Its Impact on Families

Hospitals across America have routinely drug tested newborns and pregnant patients for decades, often without medical justification. Dr. Sharon Ostfeld-Johns at Yale New Haven Health began questioning this practice and discovered a troubling pattern: the tests rarely inform treatment or protect babies. Instead, positive results trigger child welfare investigations that separate families, disproportionately affecting Black mothers and low-income patients on Medicaid.^[1]

Case Study: False Positives and Custody Loss in Georgia

Daydrianna Hefner lost custody of her two daughters for three years based on positive drug screens from a Georgia laboratory.^[1] Independent testing later proved she was sober.^[2] The problem: Georgia’s contracted labs were not performing the DL isomer test, which distinguishes legal medications from illegal drugs.^[5] Hefner spent approximately $1,000 on independent tests to prove her innocence.^[7] Some subcontracted Georgia labs have documented histories of false positives, yet the state does not require the specialized testing that would prevent these errors.^[3][6]

Consequences of Labor Drug Testing and Child Welfare Actions

Drug testing during labor is common in America, yet most state laws do not mandate it. Hospitals perform these tests as standard practice, and child welfare authorities treat positive results as automatic triggers for investigations. The consequences are severe: families are destroyed by flawed testing protocols, and children spend months or years in foster care before anyone verifies whether the original positive test was accurate.

William Brock’s case illustrates this pattern. He lost custody of his daughter Olivia for 17 months after hair follicle tests indicated methamphetamine use.^[9] Independent drug tests proved Brock was sober.^[11] Olivia was two-and-a-half when placed in foster care and four years old when reunited with her father in 2025.^[9][10]

Dr. Ostfeld-Johns’ Investigation and Policy Change at Yale New Haven

After reviewing her own prenatal records, Dr. Ostfeld-Johns discovered she had been tested for drugs without her knowledge or consent. This prompted her to question colleagues about the practice. Most admitted they had never considered whether testing was necessary—they simply assumed it was required. Her research revealed a crucial finding: drug testing newborns rarely informs actual medical care. When Yale New Haven Health revised their policy in 2022, they established a clear standard: test only if results will change treatment. In practice, this almost never occurs. The revised approach prioritizes direct patient communication, risk assessment, and targeted testing rather than routine screening.

Comparing Standard Practices to Evidence-Based Testing Models

The contrast between standard and effective approaches reveals institutional inertia. Traditional approach: automatic drug testing with positive results automatically reported to child welfare authorities. Evidence-based approach: direct patient communication, individualized risk assessment, and testing only when medical treatment decisions depend on results. Hospital networks from California to Colorado are adopting Yale New Haven’s model. Still, most hospitals continue routine testing despite evidence showing it harms families more than it protects children.

Systemic Failures in Drug Testing and the Need for Reform

The systemic problems are clear: drug testing policies produce false positives, destroy families, and disproportionately harm Black mothers and low-income parents. Georgia’s Department of Family and Children Services announced plans to audit false positive drug screen allegations.^[8] But, an audit alone is insufficient. Parents like Daydrianna Hefner and William Brock require genuine accountability and compensation for years of family separation. Meaningful reform requires: eliminating routine testing in favor of targeted protocols, mandating specialized testing methods like DL isomer analysis, holding laboratories accountable for false positives, and requiring child welfare investigators to independently verify results before separating families.

Guidance for Patients, Providers, and Child Welfare Authorities

Pregnant patients should ask their hospital about drug testing policies in writing and understand what happens if results are positive. Healthcare providers should ask a critical question before ordering tests: will this result change my medical care? If the answer is no, the test should not be ordered. Child welfare authorities must demand better laboratory practices, require DL isomer testing, and verify results independently before removing children from families. Daydrianna Hefner’s message after her case was resolved captures the necessity of persistence: “Don’t give up until the miracle happens.”^[4] Systemic change is possible, but only through sustained pressure from patients, doctors, administrators, and investigators refusing to participate in broken systems.

Challenges and Progress in Reforming Drug Testing Policies

What happens when more hospitals follow Yale New Haven’s lead? You’d expect to see fewer children in foster care, more families staying together, better health outcomes. But there’s resistance. Some child welfare investigators rely on drug tests as easy justification for removing children. Changing that means confronting bias in the system itself. The good news? Momentum’s building. Doctors and institutions questioning hot-issues in drug testing policies are increasing. California’s already progressing. Colorado’s rethinking approaches. More hospitals are establishing criteria that actually make medical sense. The question isn’t whether change will happen—it’s whether it’ll happen fast enough to prevent families currently being separated by faulty tests.

Empowering Stakeholders to Demand Accountability and Change

If you’re a pregnant patient, here’s what you need to know: ask your hospital about their drug testing policy. Get it in writing. Know whether they’ll test without your consent. Understand what happens if results are positive. If you’re a healthcare provider, stop assuming drug testing is necessary. Ask yourself: will this result change my medical care? If the answer’s no, don’t order the test. If you’re involved with child welfare authorities, demand better lab practices. Require DL isomer testing. Verify results independently before separating families. This hot-issue won’t fix itself. It requires people at every level—patients, doctors, administrators, investigators—refusing to participate in a broken system. Daydrianna Hefner said it best: ‘Don’t give up until the miracle happens.’ Change is possible. But only if we push for it.