Massachusetts Hospital Group Doesn’t Automatically Report Neglect for Babies Born with Drugs in Systems

A major Massachusetts hospital group will no longer automatically file child abuse or neglect reports for babies who are born with illegal drugs in their systems.

Mass General Brigham, the state’s largest hospital network, announced Tuesday that babies born with “substance exposure” will no longer be immediately reported to state welfare agencies unless there are other concerns that the baby is being abused or neglected.

“‘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,” Mass General Brigham said in a Tuesday release.

An abuse or neglect report to the state should only be filed if there is “reasonable cause to believe that the infant is suffering or at imminent risk of suffering physical or emotional injury” under the new policy.

Under the new policy, hospitals will also require written consent outside of emergencies before conducting a drug test on newborns or mothers.

The hospital system cited “racial and ethnic inequities,” saying that “more punitive approaches” to substance abuse during pregnancy “disproportionately affect Black individuals.”

“Studies — including some within our system — have found that Black pregnant people are more likely to be drug tested and to be reported to child welfare systems than white pregnant people,” the hospital system said.

The previous reporting requirement for babies born with drugs in their systems was criticized because it included women taking opioid addiction medications like buprenorphine or methadone, which babies can be born dependent on.

Some women have reported stopping their medications out of fear of losing custody of their babies.

The new policy is meant to “reduce stigma” and improve access to substance abuse treatment, the hospital group said.

“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,” said Sarah Wakeman, the hospital system’s senior medical director for substance use disorder.

“The goal here is balancing the safety of infants and families,” Wakeman said.“A positive toxicology test does not tell you anything about someone’s ability to parent. Actually, a positive buprenorphine test tells you this person is engaged in treatment.”

Mass General Brigham has labor rooms in both Massachusetts and New Hampshire.

Boston Medical Center previously made a similar change to its policy on reporting newborns born dependent on drugs their mother was taking.

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