In Kentucky, healthcare providers test both the mother and her newborn baby if they suspect the mother was using drugs while she was pregnant.
- When a pregnant mother ingests drugs, the substance passes through the womb to the baby, causing the newborn to become dependent along with the mother.
- Once the child is delivered, they are longer receiving drugs from the mother and start to experience withdrawal that require immediate treatment.
This condition, known as Neonatal Abstinence Syndrome or NAS, has gained national attention because the opioid crisis has caused a surge in babies born with NAS complications.
Although new mothers cannot be prosecuted criminally for using drugs while pregnant, Kentucky considers it child abuse if any baby is born withdrawing from drugs that the mother took while pregnant.
Page Contents: Requirements | How Tests are Conducted | Testing Positive | NAS | Pregnancy and Addiction
What is required for a hospital to order a drug test for a newborn?
Most hospitals do not test every new mother and her child for drugs. Typically, drug tests are only ordered if drug use is suspected or if the baby develops withdrawal-like symptoms after birth.
The ANGELS Neonatal Guidelines, followed by most medical providers, recommends a drug test be conducted if any of the following are true:
- History of maternal drug use or agitated/altered mental status in the mother
- No prenatal care
- Unexplained separation of the uterus and placenta before childbirth (placental abruption)
- Unexplained complications in the newborn’s central nervous system (e.g. seizures, brain hemorrhages)
- Symptoms of drug withdrawal in the newborn (abnormally rapid breathing, tightened muscles, excessive stooling)
- Changes in the behavioral state of the newborn (jittery, fussy, lethargic)
How are drug tests conducted on newborns in 2021?
As of 2021, most hospitals in Kentucky use risk-based testing. This means doctors only order a drug test on the baby when they suspect the mother is using drugs.
Universal testing, where a hospital drug tests every new baby that is born, is much less common but becoming more popular since the opioid epidemic increased the number of babies born addicted.
If doctors suspect that a newborn baby has NAS, they will send the baby’s meconium (stool) or urine to a lab to determine what type of substances are present in their system. A simple urine test is usually also given to the mother.
If the results of either test are positive, the doctor is required to report it to the Kentucky Department of Community Based Services.
What happens if a baby tests positive for drugs in their system?
If a baby tests positive for drugs in Kentucky (and most other states), doctors will keep them in the hospital for about four to seven days to treat withdrawal symptoms and make the child as comfortable as possible.
Once doctors confirm that the baby has NAS, they begin the process of reporting it to Child Protective Services:
- The baby is evaluated and treated for about 4-7 days. NAS is noted in the child’s medical charts
- Doctors usually report the case to the Kentucky Department of Community Based Services (only about 85% of NAS cases are reported)
- Kentucky DCBS usually opens a child abuse investigation (only about 76% of reported cases are investigated)
- A caseworker follows up with mother and child to determine if the child is being neglected
- If neglect is confirmed, the case goes to family court
- Family court determines if the baby should be removed from the care of the mother
Typically, mothers that give birth to a child with NAS are given two options – get professional addiction treatment within 90 days of the baby’s birth or have their parental rights taken away. (Kentucky Medicaid covers rehab).
While this may seem harsh, the goal of these laws is not to punish mothers for doing drugs, but to keep the child safe.
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 lifelong issues.
Babies who are born with NAS require extra care and attention, and many stay in the hospital for a few days to a week to monitor their symptoms and progress. Doctors administer a morphine taper to gently lower their tolerance without sending them into full withdrawals.
What are the symptoms of Neonatal Abstinence Syndrome?
Babies with Neonatal Abstinence Syndrome start showing symptoms within the first few days of their birth. Symptoms can include, but are not limited to:
- 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 term NAS usually refers to opiates, but most drugs can pass from a pregnant mother to her baby. The symptoms that a newborn with NAS experiences vary depending on the type of drug 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.
What if I’m pregnant and I need help with addiction?
Get help! You and your baby are better off in treatment – even if you already used drugs while pregnant. Detoxing cold turkey puts you and your baby at risk. 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.
Additionally, there are outpatient options throughout Kentucky:
JourneyPure.com doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, count records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the fields and their own personal recovery.
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(2021). Kentucky Revised Statutes. Kentucky General Assembly; Kentucky Legislative Research Commission. https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=50037
(2020, September). Neonatal Abstinence Syndrome Reporting Registry – Annual Report 2019. Kentucky Cabinet for Health and Family Services; Kentucky Department for Public Health. https://chfs.ky.gov/agencies/dph/dmch/Documents/NASReport.pdf
Farst, K. (2009, September 3). Newborns Exposed to Illicit Drugs In-Utero. University of Arkansas for Medical Sciences. https://angelsguidelines.com/guidelines/newborns-exposed-to-illicit-drugs-in-utero-discussion-of-garretts-law/
(2016, January). KY Neonatal Abstinence Reportable Disease Guidance. Kentucky Cabinet for Health and Family Services. https://chfs.ky.gov/agencies/dph/dmch/Documents/NASHospitalReportingGuidanceDocumentupdated1616.pdf
(2019, June). NEONATAL ABSTINENCE SYNDROME (NAS). March of Dimes. https://www.marchofdimes.org/complications/neonatal-abstinence-syndrome-(nas).aspx
(2019, June). PREVENTING NAS IN YOUR BABY INFOGRAPHIC. March of Dimes. https://www.marchofdimes.org/pregnancy/preventing-nas-in-your-baby-infographic.aspx
Neonatal Abstinence Syndrome. Stanford Children’s Health. Retrieved 7/29/21, from https://www.stanfordchildrens.org/en/topic/default?id=neonatal-abstinence-syndrome-90-P02387
Neonatal Abstinence Syndrome (NAS). North Carolina Pregnancy & Opioid Exposure Project. Retrieved 7/29/21, from https://ncpoep.org/guidance-document/neonatal-abstinence-syndrome-overview/neonatal-abstinence-syndrome-nas/
Jansson, L. M., Velez, M., & Harrow, C. (2009). The opioid-exposed newborn: assessment and pharmacologic management. Journal of opioid management, 5(1), 47–55.
Syme, M. R., Paxton, J. W., & Keelan, J. A. (2004). Drug transfer and metabolism by the human placenta. Clinical pharmacokinetics, 43(8), 487–514. https://doi.org/10.2165/00003088-200443080-00001
Logan, B. A., Brown, M. S., & Hayes, M. J. (2013). Neonatal abstinence syndrome: treatment and pediatric outcomes. Clinical obstetrics and gynecology, 56(1), 186–192. https://doi.org/10.1097/GRF.0b013e31827feea4
Disclaimer
All content is for informational purposes only. No material on this site, whether from our doctors or the community, is a substitute for seeking personalized professional medical advice, diagnosis or treatment. Never disregard advice from a qualified healthcare professional or delay seeking advice because of something you read on this website.
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Becca says: I was taking full spectrum cbd for a medical condition I have I stopped when I found out I was pregnant witch was around mid second trimester my I just gave birth and my Dr’s said something about a positive drug test should I be worried
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Shelby miller says:
I’m almost 21 weeks and maybe smoke twice a month. Will they be able to detect my weed usage and use it against me and take my baby
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Rachel J says:
I smoked Marijuana up until I got a positive pregnancy test then completely stopped. I failed for thc at my first dr visit nd ill probably fail this I dont think its out of my system yet. Do I tell my Dr that ive stopped? Am I going to lose my baby if I fail this one too I haven’t smoked but im afraid its still in my system. Will cps be involved?
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Dr. Stephen Loyd M.D. says: Hi Rachel, All great questions!
Even if the marijuana is not 100% out of your system for your second test, the doctor should be able to tell that the levels of THC in your system have decreased since the first time you were tested. There is no need to tell the doctor that you stopped, he or she will be able to see that based on your results.
Because you stopped smoking once you found out you were pregnant, it’s very unlikely that CPS will get involved.
Keep doing what you’re doing, you are heading in the right direction!
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Tifany says:
My newborn failed a urine test for marijuana in Kentucky. Are they going to take my baby away?
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Dr. Stephen Loyd M.D. says:
Hi Tifany, thank you for your comment! Child Protective Services will investigate the case, but aren’t going to take your baby away because he or she tested positive for marijuana. What CPS is really worried about are babies who are born withdrawing from opioids or born into households where they will be abused or neglected. In these cases, CPS will step in.
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Rachel says:
I just had a baby at central baptist in lex. I peed in a cup right when I got to the hospital in labor, but there is no record or test results showing on my chart online. They knew I smoked weed and was prescribed a medication by a dr. Nothing was ever said while I was at the hospital for 5 days, but once I got home, somebody reported that my baby had morphine in his umbilical cord blood. It 1000% was not from me, and now I have no way of proving it. Shouldn’t they had tested that urine sample I gave them right before giving birth?!
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Jamie says:
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.
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Dr. Stephen Loyd M.D. says:
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!
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Clara says:
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?
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Dr. Stephen Loyd M.D. says:
Hi Clara. Even if your doctor hasn’t mentioned a failed test, it doesn’t necessarily mean that they haven’t been testing you without you knowing it. If you failed for marijuana, they are required to note that in your chart and will test you again before birth.
My advice would be to stop smoking now. Child Protective Services isn’t going to take your baby because you tested positive for marijuana once, but a pattern of drug use will raise red flags. If you aren’t able to quit by yourself, there are treatment programs that specifically help pregnant women. You can do this!
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Amber says:
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?
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Dr. Stephen Loyd M.D. says:
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.
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jessica says:
what if i did pain pills that were not prescribed to me while pregnant? will my baby be taken from me?
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Alyssa says:
I stopped smoking when I found out I was pregnant, then failed a drug test at obgyn at 14 weeks, what will happen?
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Dr. Stephen Loyd M.D. says:
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.
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abby says:
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-
Dr. Stephen Loyd M.D. says:
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.
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Grace says:
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?
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Dr. Stephen Loyd M.D. says:
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.
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Dr. Stephen Loyd M.D. says:
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.
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Dr. Stephen Loyd M.D. says:
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.
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Dr. Brian Wind Ph.D. says:
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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Dr. Stephen Loyd M.D. 
Tifany 
Rachel 
Jamie 
Clara 
Amber 
Alyssa 
abby 
Grace 
Jessica 
Joan Hackley 
Dr. Brian Wind Ph.D.
What will happen if the baby test positive for just marijuana?
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.
I stopped smoking when I found out I was pregnant, then failed a drug test at obgyn at 14 weeks, what will happen?
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.
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?
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.
I wonder if drugs are found in the cord screen, will the baby be removed?
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.
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.
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
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.
My newborn failed a urine test for marijuana in Kentucky. Are they going to take my baby away?
Hi Tifany, thank you for your comment! Child Protective Services will investigate the case, but aren’t going to take your baby away because he or she tested positive for marijuana. What CPS is really worried about are babies who are born withdrawing from opioids or born into households where they will be abused or neglected. In these cases, CPS will step in.
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.
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!
I’m almost 21 weeks and maybe smoke twice a month. Will they be able to detect my weed usage and use it against me and take my baby
I smoked Marijuana up until I got a positive pregnancy test then completely stopped. I failed for thc at my first dr visit nd ill probably fail this I dont think its out of my system yet. Do I tell my Dr that ive stopped? Am I going to lose my baby if I fail this one too I haven’t smoked but im afraid its still in my system. Will cps be involved?
Hi Rachel, All great questions!
Even if the marijuana is not 100% out of your system for your second test, the doctor should be able to tell that the levels of THC in your system have decreased since the first time you were tested. There is no need to tell the doctor that you stopped, he or she will be able to see that based on your results.
Because you stopped smoking once you found out you were pregnant, it’s very unlikely that CPS will get involved.
Keep doing what you’re doing, you are heading in the right direction!
I just had a baby at central baptist in lex. I peed in a cup right when I got to the hospital in labor, but there is no record or test results showing on my chart online. They knew I smoked weed and was prescribed a medication by a dr. Nothing was ever said while I was at the hospital for 5 days, but once I got home, somebody reported that my baby had morphine in his umbilical cord blood. It 1000% was not from me, and now I have no way of proving it. Shouldn’t they had tested that urine sample I gave them right before giving birth?!
I was taking full spectrum cbd for a medical condition I have I stopped when I found out I was pregnant witch was around mid second trimester my I just gave birth and my Dr’s said something about a positive drug test should I be worried
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?
Hi Clara. Even if your doctor hasn’t mentioned a failed test, it doesn’t necessarily mean that they haven’t been testing you without you knowing it. If you failed for marijuana, they are required to note that in your chart and will test you again before birth.
My advice would be to stop smoking now. Child Protective Services isn’t going to take your baby because you tested positive for marijuana once, but a pattern of drug use will raise red flags. If you aren’t able to quit by yourself, there are treatment programs that specifically help pregnant women. You can do this!
what if i did pain pills that were not prescribed to me while pregnant? will my baby be taken from me?
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?
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.