Do Hospitals in Kentucky Drug Test Newborns?

Do Hospitals in Kentucky Drug Test Newborns? header image

Kentucky is one of only four states that conduct drug testing for both the mother and the baby if a healthcare provider suspects drug use because it’s considered child abuse when a baby is born with drugs in their system in Kentucky. This HB1 law took effect in Kentucky in July 2018.

In the state, 1.5 out of every 100 babies are born withdrawing from drugs (medically called neonatal abstinence syndrome).

What is required for a hospital to order a drug test for a newborn in Kentucky?

The ANGELS Neonatal Guidelines for conducting a drug test on a newborn or pregnant mother include: 

  1. History of maternal drug use or agitated/altered mental status in the mother
  2. No prenatal care
  3. Unexplained separation of the uterus and placenta before childbirth (placental abruption)
  4. Unexplained complications in the newborn’s central nervous system (e.g. seizures, brain hemorrhages)
  5. Symptoms of drug withdrawal in the newborn (abnormal rapid breathing, tightened muscles, excessive stooling)
  6. Changes in the behavioral state of the newborn (jittery, fussy, lethargic)

What happens if a baby tests positive for drugs in their system in Kentucky?

Because it is ruled as child abuse, mothers who birth babies addicted to drugs are given two options – get professional addiction treatment within 90 days of the baby’s birth or have their parental rights taken away. When parental rights are removed, it does not automatically result in the removal of the baby from the mother’s custody. The issue goes to family court.

What is Neonatal Abstinence Syndrome (NAS)?

NAS is a group of conditions caused when a baby withdraws from drugs due to exposure in the womb. The symptoms are similar to adult withdrawal symptoms, but with serious potential for life long issues.

What are the symptoms of Neonatal Abstinence Syndrome?

  • Tremors
  • Seizures
  • Twitching
  • Tight muscle tone (hypertonicity)
  • Abnormally rapid breathing (tachypnea)
  • Fever
  • Sweating
  • Problems sleeping
  • Excessive yawning
  • Poor feeding or sucking
  • Diarrhea
  • Vomiting
  • Sneezing
  • Stuffy nose

The symptoms that a newborn with NAS experiences depend on the type of drug(s) that the mother was abusing and their gestational age at birth. 

What are the long-term consequences of Neonatal Abstinence Syndrome (NAS)?

Some babies go on to live full, healthy lives free of health complications despite having NAS at birth. Many other babies experience chronic issues associated with this condition, such as:

  • Increased risk for sudden infant death syndrome (SIDS)
  • Developmental delays
  • Motor problems related to the bones and muscles and the function of them
  • Behavioral problems
  • Learning problems
  • Complications with vision
  • Regular ear infections
  • Problems sleeping

It is often misconstrued just how serious neonatal abstinence syndrome is both in the moment and over time.

How are drug tests conducted on newborns in 2020?

To test a newborn baby suspected of having NAS, their meconium or urine is tested to determine what type or combination of substances are in their system. A simple urine test is usually also given to the mother. If test results come back positive, treatment begins to keep the newborn as comfortable as possible during withdrawal.

As of 2020, most hospitals in Kentucky still use risk-based testing. This means doctors only order a drug test on the baby when they suspect the mother is using drugs. However, universal testing is becoming more popular since the opioid epidemic increased the number of babies born addicted.

What if I’m pregnant and I need help with addiction?

Get help! You and your baby are so much better off in treatment – even if you already used drugs while pregnant. Detoxing cold turkey could put you and your baby at risk and Suboxone can be an option even while pregnant.

JourneyPure has a Bowling Green Rehab that serves those addicted to alcohol or drugs across Kentucky. The center is medically equipped and regionally recognized for treating pregnant women.

We also partner with a sober living called Baby Steps to stay sober in the first months of motherhood. (Baby Steps is across the border in Tennessee).


March of Dimes: “Neonatal Abstinence Syndrome.”
Lexington Herald-Leader: ” Tide of opioid-dependent newborns forces doctors at UK, other hospitals to rethink treatment.”
National Institute on Drug Abuse: “Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome.”
Internationals Journal of Pediatrics: “Drug Testing for Newborn Exposure to Illicit Substances in Pregnancy: Pitfalls and Pearls.” “New law makes it easier for state to take babies exposed to drugs by their mothers.”


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  1. I think in Kentucky, small area where the hospital in closest to doesn’t have a labor and delivery ward. I ingested thc through 19 weeks, my midwife would prescribe Zofran until 16 weeks. I did self disclose that I smoked weed everyday until I found out I was pregnant, but I did smoke heavily for about 6 years. So I knew I was going to fail my first blood test at 9 weeks which I did but they never brought up. Am I going to lose my child if she test positive because if that’s the case I feel like my healthcare provider should at least give me some kind of notice. I had to quit my job do to being so sick and explained this to my midwife at my first appointment, I couldn’t eat and asked in the first trimester for something but was told I need to wait because there is less of a risk factor after the second trimester. I’m 27 weeks now and I am in a constant state of terror and panic.

    1. Jamie, it is very unlikely that you would lose your child in this case. In order to take your baby, the state has to prove that you are unable to parent due to drug abuse. There have been cases in the past where state agencies try to take custody away from the parent due to marijuana use, but these cases are rare. Most of the time when the state intervenes, it’s because the baby was born in opioid withdrawals or there are other complications that point to drug use during pregnancy. Best of luck to you and your baby!

  2. I live in Lou Ky, and have smoked marijuana much of my pregnancy (in 3rd trimester now) my OB has not mentioned a failed test, or anything during urine samples. Will my baby be tested at birth still?

  3. i’m 32 weeks an i live in kentucky & i did a pain pill, will that effect my baby an possibly get her taken away from me?

    1. Hi Amber, taking one dose of pain medication won’t do any permanent damage to your baby. However, if you continue taking them, you’d be putting your baby at risk for things like birth defects and preterm delivery.

      As far as custody is concerned, the state can’t take your baby away unless they see a pattern of drug abuse or the baby is born in withdrawals. Taking one pill isn’t enough for the state to take your child away because it is not enough evidence to prove you are incapable of caring for your child.

  4. what if i did pain pills that were not prescribed to me while pregnant? will my baby be taken from me?

  5. I stopped smoking when I found out I was pregnant, then failed a drug test at obgyn at 14 weeks, what will happen?

    1. Thanks for your question, Alyssa! Your physician will note the positive test results in your medical chart. In most states, it’s your doctor’s choice whether or not they report the results to child protective services. Usually, they only do this if they feel the mother will be neglectful due to their drug use.

      Even if your doctor does report the results of the drug screen, that doesn’t mean that CPS will try to take away your baby. CPS will likely follow up again after delivery. If they don’t find any abuse or neglect happening, they won’t take it any further.

  6. I’m 24 weeks pregnant and live in Kentucky. i smoked last week (marijuana) and i’m just worried about birth.
    i don’t want my daughter taken away from me i just slipped up because i was nauseous and couldn’t eat. Am i going to be okay if i am full term? thanks

    1. Hi Abby, thanks for your question. Child protective services can’t take away your daughter because you smoked marijuana one time. There would need to be some form of neglect or abuse happening for CPS to step in. That said, using marijuana during pregnancy can cause health complications for the baby. If you’re having trouble quitting by yourself, consider getting help at a program that specializes in treating pregnant mothers.

  7. If a baby has no drugs in it’s system at birth (urine or meconium), and Mom has no drugs in her system at birth, will they still test the cord for the last 20 weeks? If they do and it comes up positive, will baby be taken from Mom?

    1. Thanks for your question, Grace. Hospitals and healthcare providers typically use the baby’s meconium for the drug screen. If no drugs are found in the meconium, it’s unlikely they would then test the umbilical cord too. It’s usually one or the other.

      However, the rules for drug testing vary from hospital to hospital, so it depends on where you go. Some hospitals test every baby born there, and others only test when there is suspicion of drug use. I called the largest hospitals in the three largest cities in Kentucky and none of them test the umbilical cord without suspicion. (U of L Hospital, Baptist Health and Med Health Center)

      If the baby’s test comes back positive, physicians in Kentucky are required to report it to Child Protective Services. That doesn’t necessarily mean the baby will be taken away, though. A positive drug screen alone is not enough for CPS to remove the child.

    1. Hi, Jessica. When a baby tests positive for marijuana, it is at the doctor’s discretion whether to report the case to child protective services. If reported, CPS could then launch their own investigation to see if there is further abuse or neglect taking place. However, the positive marijuana test itself is not enough evidence to prove a child is being abused or neglected.

  8. I wonder if drugs are found in the cord screen, will the baby be removed?

    1. Great question, Joan! Doctors can use tissue from the child’s umbilical cord to determine whether they have been exposed to substances. They can also use the baby’s urine, blood, meconium or hair samples. Most of the time, doctors will use the baby’s urine because collecting it is non-invasive and yields the quickest results. From there, the Kentucky Cabinet for Health and Family Services would be in charge of investigating and if necessary, taking action to remove the baby from the custody of the mother.

    2. Hi Joan! It looks like Dr. Loyd focused on the medical wording in your question. Here is something you might find helpful. In Kentucky, a positive cord screen alone does not warrant the removal of the baby from the mother. If drugs are found in the baby’s cord screen, the physician would report those results to Child Protective Services. CPS will then investigate to see if the mother is neglectful and unfit to be a parent. The positive cord screen, without further evidence of neglect, is not enough to justify taking the baby away from the mother.

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