How some Alabama hospitals quietly drug test new mothers — without their consent

In Alabama, a positive drug test can have dire repercussions for pregnant women and new mothers. Their newborns can be taken from them. They can lose custody of their other children. They can face lengthy sentences in the most notorious women’s prison in the United States and thousands of dollars in fees and fines.

Yet the hospitals that administer those drug tests — and turn the results over to authorities — are exceedingly reluctant to disclose their policies to the public. In many cases, they test mothers and babies without explicit consent and without warning about the potential consequences, ProPublica and AL.com have found.

According to a review of hundreds of court records, drug testing is ubiquitous in some Alabama counties — sometimes of mothers, sometimes of infants, sometimes both. In some parts of the state, hospitals test on a case-by-case basis, employing criteria that virtually ensure greater scrutiny for poor women.

ProPublica and AL.com began examining hospital drug-testing policies as part of an investigation into Alabama’s chemical endangerment law, the country’s toughest law targeting drug use in pregnancy. Since 2006, the law has been used to charge nearly 500 women with endangering their unborn children. In many cases, law enforcement officials cited hospital-administered drug tests as probable cause for arrest.

Forty-two of the 49 hospitals that deliver babies in Alabama declined to answer an AL.com/ProPublica questionnaire about testing policies, despite repeated requests over several months. Of the seven that did respond, three provided only partial information. Officials at several hospitals declined interview requests to explain why they didn’t want to answer the questionnaires...................

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