More than 70,000 reports of alleged substance use during pregnancy have been made to law enforcement agencies across the United States, a figure experts believe represents a significant undercount of the practice.
The data, compiled through public records requests and reported by The Marshall Project and North Carolina Health News, reveals a widespread, yet often obscured, practice of flagging pregnant individuals to police based on positive drug tests. These tests, frequently conducted during routine prenatal care, have led to investigations, and in some cases, criminal charges, raising concerns about the potential for flawed science and the disproportionate impact on marginalized communities.
The reports span multiple states, with varying legal frameworks governing how these cases are handled. Some states have laws explicitly criminalizing substance use during pregnancy, while others rely on existing child welfare laws to intervene. The National Partnership for Women & Families has highlighted the unreliability of these tests, noting that false positives are common and can have devastating consequences for expectant mothers and their families.
According to reporting, the practice began gaining traction in the 1980s amid heightened concerns about the “crack epidemic.” While the focus has shifted over time to include opioids and other substances, the underlying approach of involving law enforcement in prenatal care remains prevalent. The Marshall Project’s investigation details how hospitals and medical providers often operate under a lack of clear guidance, leading to inconsistent reporting practices and a lack of due process for those accused.
The implications of these reports extend beyond the immediate legal consequences. Mothers flagged to police may face increased scrutiny from child protective services, potentially leading to the removal of their children. The fear of legal repercussions can also deter pregnant individuals from seeking necessary medical care, jeopardizing their health and the well-being of their babies. The Marshall Project reported on the difficulties in tracking these cases, noting that many reports are not publicly accessible and that data collection methods vary widely across states.
Advocates argue that addressing substance use during pregnancy should be a public health issue, not a criminal one. They call for increased access to treatment and support services for pregnant individuals struggling with addiction, rather than punitive measures that can exacerbate the problem. The North Carolina Health News reported that the state experienced a particularly high number of these referrals, prompting calls for policy changes and greater oversight of drug testing practices.
The exact scope of the problem remains unclear, as comprehensive data is lacking. However, the available evidence suggests that tens of thousands of mothers have been subjected to unwarranted police scrutiny based on flawed or misinterpreted drug tests. The National Partnership for Women & Families continues to advocate for policies that protect the rights and well-being of pregnant individuals and their families, emphasizing the need for evidence-based approaches to address substance use during pregnancy.
As of February 21, 2026, no federal legislation has been proposed to address the issue, and state-level reforms remain fragmented. The Marshall Project is continuing to track reports to police about drug use during pregnancy, with plans to release updated findings later this year.
