Doctors in the United States are increasingly conducting drug tests on pregnant women without their consent and reporting positive results to state authorities. According to a report by the Legislative Analysis and Public Policy Association, in 24 states and Washington, D.C., a positive drug test alone can initiate a child welfare report. This can result in mothers being placed on child abuse registries, sometimes without prior notification.

Enrima Ukoha, an obstetrician-gynecologist and maternal-fetal medicine specialist at Mount Sinai Hospital in New York, described the practice known as "test and report" as "common" and often conducted in non-consensual ways. Over six years, The Marshall Project documented at least 70,000 cases across 21 states where parents were referred to law enforcement following positive drug or alcohol tests.

The 1974 federal law mandates that states develop "plans of safe care" for infants identified as affected by substance abuse or withdrawal symptoms and requires healthcare providers involved in the delivery or care of these infants to notify child protective services. However, the law explicitly states it should not be interpreted as requiring prosecution for illegal actions.

Cases highlight the severity of consequences: Idaho mother Nicole Hamann was placed on the state's child protection registry for 10 years after a single positive THC test, as reported jointly by CBS News and The Marshall Project. Similarly, in South Carolina, Ayanna Harris-Rashid was arrested and faced a 10-year felony sentence after testing positive for THC.

These developments raise concerns about the balance between protecting infants and respecting the rights and consent of mothers undergoing drug testing during pregnancy.

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