A major hospital network in Massachusetts has updated its policies and will no longer report suspected child abuse or neglect based solely on a newborn baby testing positive for drugs.
It follows an analysis of policies that “may unwittingly perpetuate structural racism,” hospital system officials said, adding that substance abuse disorder is a condition with “significant racial and ethnic inequities,” more so when it comes to pregnancy.
According to the update, black pregnant women are more likely to be drug tested and reported to welfare agencies than white pregnant women.
In an effort to address these “inequities in substance use disorder,” Massachusetts General Brigham is creating a “systemwide policy to support pregnant people and their infants to ensure a standardized and equitable approach to toxicology testing and reporting.”
The hospital aims to “reduce barriers to treatment that have disproportionately impacted patients of color while prioritizing practices that support the safety and wellbeing of families impacted by SUD,” it said.
Under the new policy, hospitals within the Massachusetts General Brigham system will now require written consent before conducting a drug test on the expectant mother or infant, except in emergencies.
New Policy Rules
Medical staff will now only file a report of suspected abuse or neglect to state child welfare agencies in Massachusetts and New Hampshire if there is “reasonable cause” to believe a child is “suffering or at imminent risk of suffering physical or emotional injury” and that “substance exposure alone, including treatment with methadone or buprenorphine for opioid use disorder, does not require a report of abuse or neglect in the absence of protective concerns for the infant.”“Our new perinatal testing and reporting policy is the latest step in our efforts to address longstanding inequities in substance use disorder care and to provide compassionate, evidence-based support to families while addressing substance use disorder as a treatable health condition,” Sarah Wakeman, the system’s senior medical director for substance use disorder said in a statement.
“This policy reflects an emerging consensus, based on sound science, that is being embraced by our peer institutions and was developed in coordination with a wide range of partners,” Ms. Wakeman added.
‘Policies Create Undue Risk’
The report also stated that pregnant women with substance abuse disorders should be encouraged to access support and care systems, and barriers to access should be removed wherever possible.“One important way to achieve this is to update policies that automatically trigger mandatory filings with child welfare agencies when a pregnant individual is engaged in treatment for substance use disorder, absent any other concerns for potential abuse or neglect,” Massachusetts General Brigham’s press release said.
“Health equity leaders note that these policies create undue risk that pregnant people might be separated from their newborn infants and discourage them from accessing treatment. These policies disproportionately impact patients from historically marginalized populations,” it added.
Speaking to The Boston Globe, Ms. Wakeman noted the updated policy is allowed under a revised interpretation of state law.
“We would never make a change that was illegal,” she told the publication.
Massachusetts General Brigham is not the only hospital system to adopt such a policy on reporting suspected abuse and neglect. The Boston Medical Center also quietly revised its policy in 2021, according to reports.
