for the drug testing, as with most answers when it comes to pre natel care: it depends.
From what I understand, many factors will determine whether a new mom is drug tested or not. In most cases, if the woman is scheduling regular pre natel appointments, the pregnancy is progressing without conplications, the mothers bloodwork apears normal (no strange liver enzyme elevations indicitive of drug and/or alcohol use), and of course the bebe is delivered without major issues, they typically will not test.
In most states it’s SOP to test all pregnant women, regardless of previous prenatal care but they would have been tested already by their OBGYN if they had regular care.
After the meth and OxyContin (rx pill epidemic) they had a big problem with pregnant women of all backgrounds using drugs, but lying about it, because if you tell a doctor you are using drugs CPS is going to be contacted.
This includes women getting regular, Private insurance care. A drug screen is done on at least one of the endless urine samples pregnant women give at monthly appointments and many insurance companies mandate this because they want to know if they have a high-risk or possible NICU baby issue and try to avoid it.
Upon admitting to a hospital for delivery they immediately run a drug screen via urine sample because they know the chances of a pregnant woman in labor being honest about drug use is very low. Once again if a woman in labor admits to active drug use CPS will be called but the medical team must know if there has been active drug use for the health and safety of the baby and mother.
Most women never even know they had the drug screens run because if it doesn’t come back positive nothing is ever said. The doctors and hospitals never mention they are going to do them unless they are already confronting a woman about possible drug use due to very obvious red flags.
If you have private insurance, and bother to go through your billing for the endless tests done during pregnancy, you will find at least one drug screen done along with the litany of all the other screens done. I know this because a few years ago I got a bit offended when I saw my insurance had been billed $15 for a drug screen by my OBGYN. Did he think I was some druggie!?! But I but found out almost all private insurance mandate one drug screen done during prenatal care. However, I would have never had a clue it had been run on me had I not gone through my insurance billing line by line and recognized the lingo for a standard 5 screen drug panel. Most pregnant women who don’t use drugs never know these tests are run because it’s never mentioned unless you test positive for illicit substances.
I talked to the doctor about it and he said even if he wasn’t required by insurance he would do them anyway, because it’s just not something they can trust to be self-reported and it’s critical they know if any drugs (legal or illegal) are in a pregnant woman’s system.
This is why there is a weird niche of home birth people who want to have a non-medicalized homebirth because they are using drugs - whether it’s just weed or harder stuff. Idk if it’s still the case, but even weed would be reported to CPS and could result In inquiries.
It is more invasive when the woman is on Medicaid for her healthcare because they have a lot more mandated testing and interventions than women using private insurance. If you are poor enough to qualify for Medicaid you are already in a higher-risk group for drug use and other issues they monitor. This is generally the population the drug-using home birth er niche springs from. They know the only medical coverage they can get is via Medicaid and they know their drug use and other issues will be closely monitored by Medicaid funded care providers because it’s part of the requirements for all pregnant women covered by Medicaid. They want to avoid detection of their drug use and CPS/ social worker looking into their living conditions and think opting out of the system all together by going the home birth route is the best solution. (This obviously isn’t the majority of home birthers, who tend to be obsessive purists with what they put into their bodies, but they do make up a significant but small minority. They are like the grungy dirt bags of the home birth population.)
