Does the OB-GYN Test For Drugs During Pregnancy? Know the Truth Behind It! 

Written by Daisy
Last updated:
Reviewed by Margaret

The article has been reviewed by medical expert Margaret Dogwood, BSN, RN

Have you ever wondered – does the OB-GYN test for drugs during pregnancy? I guess it never occurred to you too, right? And to answer that, yes, OB-GYNs test for drug use during pregnancy! 

This has to be one of the most-asked questions expecting mothers ask before any test – because what if it returns as false positive? 

In this guide, you will learn the truth behind OB-GYNs and whether they test pregnant women for drugs. Additionally, this post will also cover: 

  • Why Knowing This is Important 
  • Different Types of Drug Testing For Pregnant Women
  • States In the U.S. That Perform Newborn Drug Testing 
  • Drug Test Pregnancy Laws 

The Explanation of Drug Testing During Pregnancy

Don’t overcomplicate it, you’ll just confuse yourself! It is as simple as it seems! Drug testing during pregnancy is simple and easy – it is when doctors, OB-GYNs, in particular (also midwives and other healthcare practitioners), test the expectant mother or the pregnant woman and see if they come out positive in drug or substance abuse. 

This extends way past that as it will eventually include drug testing babies, screening them after they’re born. 

Do OB-GYNs Test For Drugs During Pregnancy? 

It’s a bit over-the-top, but do you believe drug testing a pregnant woman? From a personal perspective, it’s necessary considering the age we live in. As shocking as it may be, that is not the only explanation for why drug testing during pregnancy is done. 

Divergent viewpoints exist on the necessity and efficacy of drug testing during pregnancy. If there is a suspicion of drug use or a positive past, drug testing during pregnancy should be done, according to the ACOG or the American College of Obstetricians and Gynecologists.

The group also stresses that drug testing should not be used as a form of punishment and that it should place a high priority on offering assistance and treatment for substance use disorders.

As of September 1, 2010, three states consider substance misuse during pregnancy to be a reason for involuntary commitment to a mental health or substance abuse treatment institution, and fifteen states consider it to constitute child abuse under civil child-welfare statutes.”

Guidelines for screening for drugs during pregnancy are provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), which emphasize the necessity for informed consent, confidentiality, and appropriate treatment and therapy referrals.

Healthcare Providers’ Testing Policies 

What about healthcare providers, clinics, and hospitals? Do they have a hand in all of this? 

When it comes to drug use during pregnancy, healthcare providers have a variety of rules, and these policies can have a big influence on the health of both the mother and the unborn child – even newborn babies. 

Other providers could adopt a more supportive and non-punitive strategy that places a higher priority on harm reduction and substance use treatment. Some providers might have rigorous procedures including drug testing and potential sanctions for pregnant women who test positive for drugs.

Some midwives could have a rule requiring patients to submit to drug testing, while others would only do so if there is a suspicion of drug use based on the mother’s medical history or other factors. 

It would really depend on the healthcare provider and/or professional. Some won’t even dive deep and look at it! 

Can an OB-GYN Drug Test Without Consent? 

Doing anything today without consent can easily be aligned with a crime, even those that aren’t as serious as this. However, OB-GYN testing – specifically drug testing should NOT be generally done without the consent of the patient, with a few exceptions to that rule, of course. 

The ACOG says that drug testing during pregnancy may be required if there is a reasonable suspicion of drug use or a positive past. 

In other circumstances, the OB-GYN may go over the requirement for a drug test with the patient and get their permission. The OB-GYN might still be required by law to notify child protective services if the patient refuses to submit to a drug test.

In conclusion, it is possible for OB-GYNs to perform drug testing on patients if they’ve tested positive before or if there are suspicious factors that contribute to that idea.

What Are the Different Types of Drug Tests?

Now, let’s go over the different types of drug tests done on expectant mothers or pregnant women. These tests are not just limited to pregnant people, though – they’re the general method followed to inspect drug or substance abuse.  

Urine Tests

Urine testing is the most typical type of drug test used during pregnancy. 

A urine sample must be collected and sent to a lab for evaluation. Numerous substances, including opiates, cocaine, marijuana, and amphetamines, can be found in urine during drug testing.

Blood Tests

Coming in at 2nd place as “the most common form” of drug testing would be blood testing. Blood testing for drugs is a more personal and invasive sort of test as it will require taking a patient’s blood sample. 

It is more accurate than urine drug testing and can identify the presence of drugs in circulation. However, because the technique is so invasive, it is less frequently done during pregnancy.

Hair Tests

If you’re completely unaware of drug tests, this could come off as a shock or a surprise for you. A small sample of hair from the patient’s scalp is actually one of the more accurate forms of tests.

A single strand (or some strands) is taken for a hair follicle drug test, and the hair is examined for the presence of drugs. 

Drugs can linger in hair for up to 90 days, therefore this method of testing can identify drug use over a longer period of time than urine or blood tests.

I guess our “crown” reveals a lot about us and our habits, doesn’t it? 

Meconium Tests

And last but most definitely not least would be Meconium tests

The process of Meconium drug testing involves checking for drugs in the newborn baby’s first stool. This particular type of testing is often used to find drug use throughout the entire pregnancy because drugs can be found in meconium for up to 20 weeks.

These are all the different types and methods of drug testing that can be done on expectant mothers during their pregnancy cycle. 

So, what if an expectant mother tests positive? Would she face charges for drug or substance abuse? Or would she be sent to a rehabilitation center to get treatment? 

What Happens If You Test Positive? 

A pregnant patient who tests positive for drugs will normally have a conversation with her OB-GYN about the results and be informed of the risks of substance use during pregnancy. In addition to offering additional support and services, the OB-GYN may refer the patient to a program for drug and alcohol abuse.

Depending on state legislation, the OB-GYN may occasionally be obligated to notify child protective services if a patient tests positive for narcotics. This may lead to an investigation and the patient’s case perhaps including child protective services.

In other words, the end result will be dependent on the state or the area where the patient is in. 

The ACOG, in actuality, recommends OB-GYNs to be in close contact with state legislators in order to retract the ruling that apprehends women for substance abuse while they are pregnant. 

Drug Use During Pregnancy Laws 

Now, you could be formulating questions and wondering about the laws and legislation about drug and substance abuse for women. State regulations on drug usage during pregnancy differ from one another, and there is no federal law that tackles the subject expressly. While some states have laws requiring medical professionals to report possible drug use while pregnant, others do not.

Drug use during pregnancy may be seen as child abuse or neglect in some areas and states, and child protective services may become involved. On the other end of the rope, the mother can be subject to legal repercussions including losing custody or facing criminal prosecution.

Additionally, some states have passed legislation that offers pregnant women with substance use disorders treatment options rather than punishment. 

These laws may call for the provision of substance use treatment and assistance to pregnant patients, as well as funding for treatment programs, by healthcare practitioners.

The Guttmacher Institute carefully detailed the legislation from different states toward their action when a pregnant woman tests positive for drug or substance abuse. 

What States Drug Test Babies At Birth?

According to Pro Publica, Tennessee is the one and only state that has this rule that sees drug use as a crime while pregnant. 

Only Tennessee has a law that expressly makes it unlawful to consume drugs while pregnant. High courts have construed child endangerment and chemical endangerment laws in Alabama and South Carolina to permit prosecution of drug-using pregnant women and new moms.”

As you see, different states have different rules when it comes to drug testing women, babies, and even the process of drug testing itself. So, the following are the states that implemented policies for newborn screening and drug testing. 

NOTE: These are all conditional – if the mother’s drug-use history is unknown or suspected or if there is suspicion or signs of maternal drug use. 

  • Alabama
  • Florida
  • Georgia
  • Kentucky
  • Louisiana
  • Massachusetts
  • Minnesota 
  • North Carolina
  • Tennessee
  • Wisconsin

NOTE: Check out the legislation in your state about drug testing pregnant women, as well as the hospital or clinic you are in.

The following fifteen states, however, require hospital and clinic staff, as well as other workers to report drug use should they suspect it: 

  • Virginia
  • Utah
  • Rhode Island
  • Oklahoma
  • North Dakota
  • Montana
  • Minnesota
  • Michigan
  • Massachusetts
  • Maryland
  • Louisiana
  • Iowa
  • Illinois
  • Arizona
  • Alaska

That’s about it! Those are the rules, regulations, and statutes about the drug use of pregnant women.

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I am as confused as you are now when I first found out about it, believe me. That’s why I and the team decided to address and answer some of the questions that are commonly asked revolving around this topic. 

What Does the OB Check Urine For? 

Other than drug use, urine testing has been one of the best and most effective ways of having a quick read on a woman’s health, especially during pregnancy. 

The tests are done to have an early view of some conditions that could be disrupting the process – one good example would be preeclampsia. By checking the urine of a pregnant woman, OB-GYNs can tell whether or not the pregnancy is in danger or not. 

At What Week Do They Drug Test During Pregnancy? 

It depends on the situation and on what the OB-GYN recommends. I have read and heard instances where OB-GYNs request immediate drug testing when an expectant mother displays withdrawal symptoms, leading to heavy bleeding, preterm labor, and other situations.

Meconium tests are done after 24 weeks gestation, while urine testing is after 32 weeks gestation

Can Drugs Be Detected in the Placenta? 

Yes, drugs can definitely be detected in the placenta of a pregnant woman – and it’s done through a chromatography session. Marijuana, cocaine, and other types of illegal drugs and substances pass through the placenta after ingestion. Therefore, they can be traced and detected. 

Will Pregnancy Show Up In Drug Tests? 

No, it won’t. It’s funny because I had the same thought – that they work the other way around! When, in fact, they don’t. The simple explanation is that pregnancy tests try to detect chorionic gonadotropin or hCG in your urine and drug tests don’t actually test that. 

The Bottom Line 

Drug testing is actually a crucial thing to do during pregnancy. It doesn’t only allow healthcare practitioners and doctors to find out several reasons for situations, but doing so also gives them the chance to recommend correctional or rehabilitation treatment to people who need it. 

So, does the OB-GYN test for drugs during pregnancy? The answer is – they can. Although not really required and doing it will be under their discretion, it is completely legal for them to endorse expectant mothers for such testing should they suspect drug and substance use during the period. 

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Daisy Martinez, a Certified Financial Planner and mother of two, blends finance expertise from Ohio State and Anderson School of Management with hands-on parenting insights. Founder of "" and "", she's passionate about guiding parents in financial and parenting realms.

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