Pregnant with her fifth child, Susan Horton had a lot of confidence in her parenting abilities. Then she ate a salad from Costco: an “everything” chopped salad kit with poppy seeds. When she went to the hospital to give birth the next day, she tested positive for opiates. Horton told doctors that it must have been the poppy seeds, but she couldn’t convince them it was true. She was reported to child welfare authorities, and a judge removed Horton’s newborn from her care.
“They had a singular piece of evidence,” Horton said, “and it was wrong.”
Hospitals across the country routinely drug test people coming in to give birth. But the tests many hospitals use are notoriously imprecise, with false positive rates of up to 50 percent for some drugs. People taking over-the-counter cold medicine or prescribed medications can test positive for methamphetamine or opiates.
This week on Reveal, our collaboration with The Marshall Project investigates why parents across the country are being reported to child protective services over inaccurate drug test results. Reporter Shoshana Walter digs into the cases of women who were separated from their babies after a pee-in-a-cup drug test triggered a cascade of events they couldn’t control.
This is an update of an episode that originally aired in September 2024.
Dig Deeper
Read: She Ate a Poppy Seed Salad Just Before Giving Birth. Then They Took Her Baby Away. (Reveal and The Marshall Project)
Photos
Credits
Reporter: Shoshana Walter | Producer: Marianne McCune | Editor: Jenny Casas | Fact checkers: Nikki Frick and Kim Freda | Legal review: Leita Walker | Production manager: Zulema Cobb | Digital producer: Nikki Frick | Original score and sound design: Jim Briggs and Fernando Arruda | Post-production support: Claire Mullen and Missa Perron | Editorial support: Nina Martin, Manuel Torres, and Kate Howard | Deputy executive producer: Taki Telonidis | Executive producer: Brett Myers | Host: Al Letson | Special thanks: The Marshall Project data reporters Weihua Li, Andrew Rodriguez Calderón, and Nakylah Carter and researcher Catherine Odom
Support for Reveal is provided by listeners like you, and the Reva and David Logan Foundation, the John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Robert Wood Johnson Foundation, the Park Foundation, The Schmidt Family Foundation, and the Hellman Foundation.
Transcript
Reveal transcripts are produced by a third-party transcription service and may contain errors. Please be aware that the official record for Reveal’s radio stories is the audio.
| Al Letson: | From the Center for Investigative Reporting and PRX, this is Reveal. I’m Al Letson. | |
| Imagine, you’re getting ready to have a baby. You’re making plans for how the birth will play out, who’s going to be there, making sure you have everything you need to take the baby home. Car seat, check. Diapers, check. | ||
| Now, imagine the baby is born. You’re in your hospital bed, enjoying your newborn, and a doctor walks in and says… | ||
| Speaker 1: | So, I just want you to know that your urine tested positive for drugs. | |
| Speaker 2: | You tested positive for methamphetamine. | |
| Speaker 1: | You can leave, but your baby cannot. | |
| Al Letson: | This makes no sense to you, it’s totally absurd, but the doctors and nurses, they don’t believe you. | |
| Speaker 2: | I don’t know how to defend myself. What do I do to get out of this situation? I don’t even know how I got into it. | |
| Speaker 1: | I had no inkling, no idea that we would be fighting for our baby to come home with us. | |
| Al Letson: | Last week on Reveal, reporter Shoshana Walter told us about a mother who had her newborn baby taken away, after she was reported to Child Protective Services for taking a legally prescribed medication. It was to treat her opioid addiction. | |
| While Sho was reporting that story, she started hearing about more women who lost custody of their babies at birth, after testing positive for drugs. These were women who said they had no history of drug use, weren’t being treated for addiction, and weren’t using illicit drugs. | ||
| Shoshana Walter: | Women who hadn’t taken anything at all. It was just that the drug test was wrong. | |
| Al Letson: | Still, these new mothers were reported to Child Protective Services, or CPS, and were investigated. Sho decided to investigate too. | |
| This week, we’re revisiting an episode we aired last fall in partnership with the Marshall Project, tracking what Sho learned. | ||
| Shoshana Walter: | I almost didn’t believe at first that there could be instances where a woman goes into the hospital to give birth. She’s drug tested. The drug test is positive. She’s reported to CPS. CPS may even choose to remove her child, and in fact, the drug test was completely wrong, and there was never any follow-up testing to confirm it. And so… | |
| Hello? | ||
| Speaker 3: | Hello. | |
| Shoshana Walter: | I’m kind of firing on multiple fronts. | |
| Speaker 3: | Can you hear me? | |
| Shoshana Walter: | Hi. I can hear you. Say something again. | |
| One of the first things I did is, I just kind of searched for people making accusations of false positives. | ||
| Speaker 3: | He’s like, well, your urine tested positive for opiates. I said, that makes no sense. I’ve never done drugs in my life. | |
| Speaker 4: | I wasn’t uninfluenced by any drugs. | |
| Shoshana Walter: | Okay. | |
| Speaker 4: | They refused to take a new sample. | |
| Shoshana Walter: | Why? | |
| Speaker 4: | They were like, I don’t know why. | |
| Shoshana Walter: | I was entering support groups and social media spaces and finding women who claimed that they had experienced false positive results and reaching out to them. | |
| Speaker 5: | They took her. I had to leave the hospital without her. | |
| Speaker 6: | You’re not allowed to be with any of your children by yourself, for at least the next 45 days. | |
| Shoshana Walter: | I was reading through appellate court rulings and I found cases where women’s parental rights were actually terminated. | |
| Do you feel comfortable having your name in the story? | ||
| Speaker 7: | Yes, that’s fine. | |
| Shoshana Walter: | Not only do I have to get these individuals on the phone, try to earn their trust. | |
| This might be hard to talk about. | ||
| Speaker 8: | Yeah, because I get anxious. | |
| Shoshana Walter: | I also have to ask them to send me their records. | |
| Speaker 8: | When we get off the phone, I will look for all that stuff. | |
| Shoshana Walter: | That would be really great to see. | |
| As a reporter, I can’t just report people’s claims without any evidence. I really need to prove that this is affecting people who did not use illicit substances. And so, finding a clear-cut case was something I really began to focus on. | ||
| So, I’m talking to all these women and hearing these just horrific stories, but it’s actually really difficult to get all of the documentation that you need to prove one of these cases. Not everybody has the ability to do that. And then I saw this Facebook post. | ||
| It was about a woman named Susan Horton in Santa Rosa, California. We ended up exchanging messages over weeks, before she agreed to meet me in person. | ||
| This is the microphone. Hello, meet the microphone. | ||
| Susan Horton: | Oh, yes. Hi. | |
| Shoshana Walter: | I think she was really scared to revisit this experience. | |
| Also, how are you feeling about all this? | ||
| Susan Horton: | Well, I’m a pretty introverted person. I don’t have a ton of friends, and I have a lot of kids, so I’m home a lot. | |
| Shoshana Walter: | She has five kids. | |
| Susan Horton: | I’ve been a mom since I was 19, so I’ve really devoted my life to my kids, and this does make me nervous. But yeah, the more stories that are out there, hopefully, change will happen. | |
| Shoshana Walter: | Susan gave birth in the pandemic. | |
| Susan Horton: | I was super, super pregnant and everything looked fine. | |
| Shoshana Walter: | Because this was her fifth child and it was during COVID, she skipped a lot of prenatal appointments. | |
| Susan Horton: | I felt like I went to all the important ones. | |
| Shoshana Walter: | She lacked child care and both her husband and her sixteen-year-old are immunocompromised. | |
| Susan Horton: | My second born Liam was born with a congenital heart defect and had five open heart surgeries. | |
| Shoshana Walter: | So, Susan basically avoided the doctor during COVID. | |
| The night before Susan went in to give birth. | ||
| Susan Horton: | My contractions were coming on a lot stronger, and I still had to make dinner for my family, so I got the easiest thing out of the fridge, which was frozen pizza, and a salad kit from Costco. I don’t think I got much sleep that night. And by morning, I remember I was in a lot of pain. | |
| Hallie was very big. She was nine pounds, 11 ounces, and I had forgot how hard it is to birth a nine-pound baby, so the pushing out took a little longer. | ||
| Shoshana Walter: | She gave birth to this little baby girl, looked more like her than any of her other kids had previously. | |
| Susan Horton: | Oh, it’s like a little mini me, you know. | |
| Hi, baby. | ||
| It was the next morning that, I believe she was a social worker. She came in and said, “So I just want you to know that your urine tested positive for drugs.” | ||
| Shoshana Walter: | Susan was basically like, what? | |
| Susan Horton: | What? My urine? You’re sure it was mine? | |
| Shoshana Walter: | Her first instinct was, well, you must have gotten me mixed up with somebody else. And then she asked… | |
| Susan Horton: | What drug came up? | |
| Shoshana Walter: | The woman says she’s positive for opiates. Then later, she comes back and says she’s positive specifically for codeine. | |
| Susan Horton: | Cough syrup? You mean like cough syrup? And she said, “Yes, but it’s prescribed cough syrup.” So they asked me, “Were you prescribed cough syrup?” And I said, no, absolutely not. I hardly take Advil. I labor naturally. | |
| Shoshana Walter: | She’s lying down in her hospital bed, racking her brain over what she might have eaten or taken that could have caused this result, and she remembers. | |
| Susan Horton: | Ding, ding, ding. | |
| Shoshana Walter: | The pizza and the salad. | |
| Susan Horton: | A poppy seed salad. It was delicious. It had its separate little packages of dressing, and it had a separate little package of just poppy seeds. And they were so crunchy. You know when you crunch something and you can hear it in your ears and stuff, so I vividly remembered chomping down on those poppy seeds. | |
| Shoshana Walter: | After the provider leaves the room, she just does a quick Google search and she realizes, that had to be it. | |
| Susan Horton: | I have no clue what else it could be. So I tell them eventually. I’m like, 24 hours ago, for dinner, I had a salad and pizza, and that salad had a lot of poppy seeds on it. | |
| Shoshana Walter: | I know, from reading her medical records, that providers noted her shifting story. At first, she said, you must’ve gotten me mixed up with someone else, and then they noted that she changed her story to assert that it was this poppy seed salad. | |
| Multiple providers file into Susan’s room and tell Susan that, because she tested positive for opiates, they need to keep the baby in the hospital for five days to monitor for withdrawal symptoms. | ||
| Susan Horton: | “You can leave, but your baby cannot.” And I was not leaving baby, there was no way. And they’re like telling me what’s going to happen. | |
| Shoshana Walter: | That they contacted Child Protective Services, and that a CPS investigator would be coming to ask her questions. | |
| Susan Horton: | There was a point where I was just like, this is absurd. I want to go home. I have not taken anything. | |
| Shoshana Walter: | She basically argues there’s no reason for the baby to stay in the hospital because the baby is not going to experience withdrawal symptoms. That falls on deaf ears because the process has already been set in motion and the investigator is coming in a matter of hours to interview Susan. | |
| Susan Horton: | I felt very emotional, and I was alone. | |
| I just gave birth the day before. I’m not sleeping, and I just felt like really ganged up upon. They had a singular piece of evidence that I had taken something and it was wrong. | ||
| Shoshana Walter: | Susan calls her husband Colin and is basically like, I need you here. | |
| Susan Horton: | Because I’m losing it. | |
| Shoshana Walter: | So Colin comes to the hospital. His parents who are elderly go and stay at the house with the kids. And then the CPS investigator comes. | |
| Susan Horton: | And they wanted to go over some points like, “Why did you miss all the prenatal appointments? Your son has a heart condition, right? Would you miss appointments for him?” I really went off on her when she asked me that. I was like, my son has a life-threatening congenital heart defect. Of course, I would take him to every appointment or do whatever surgery needed to save his life. Not going to a prenatal appointment is not the same. Like, what is happening? | |
| Shoshana Walter: | When someone is told that they’ve tested positive for drugs and they actually haven’t taken any drugs at all, the feelings range from total shock to embarrassment, anger, shame. They’re not being believed, and for many of the families I spoke to, all of a sudden, it seemed like everything they’d ever done was suddenly suspect. So, it makes sense that, at times, these families responded defensively. | |
| Susan Horton: | They want me to sign a safety plan. | |
| Shoshana Walter: | A safety plan is essentially a voluntary agreement between a family and Child Protective Services, that may include additional drug testing. It may include inspections and searches of the home, allowing CPS to interview other people in your life. It can be a very intrusive and invasive agreement. | |
| Susan Horton: | I literally just said, I haven’t done anything. There was no reason for any of this to be taken place, and I didn’t want to sign something, almost like admitting guilt, because I was not guilty. | |
| Shoshana Walter: | But, they did not realize what the consequences would be if they did not sign it. | |
| Susan Horton: | Basically, as soon as I made the choice to not sign, she stomped out. I didn’t know this at the time, but she was getting a judge to sign a paper to take away my baby. | |
| Shoshana Walter: | Around the same time that I started talking to Susan, I was reaching out to other families, and Grace and Michael Smith had had this experience at a hospital in Pennsylvania. Their case is a little bit different from Susan’s, because instead of poppy seeds, it actually involves Grace’s prescribed medication. They had just moved to the Poconos to be closer to Grace’s parents, when essentially, Grace went into labor with their fourth child. | |
| Grace Smith: | I called Michael and I was like, okay, my water broke. We got to go. And then me and Michael went in to have a baby. Everything seemed to be fine. | |
| Michael Smith: | He grabbed my finger and I told him that I was going to love him for the rest of his life. | |
| Grace Smith: | And everybody in the room just got really quiet and they’re aww. | |
| Shoshana Walter: | When did you get the sense that something might be going awry? | |
| Michael Smith: | It was the following day when they started talking to us about trying to get him into the NICU. | |
| Shoshana Walter: | Doctors seemed to think that their son was developing respiratory issues, so they took him to the neonatal intensive care unit. Shortly after that, the OB-GYN started asking Grace and Michael some questions, why they moved. What do they do for a living? Grace told the doctor that she’s a lawyer and Michael is a stay-at-home homeschooling dad who also went to law school. And then finally, the doctor told them. | |
| Grace Smith: | Well, you tested positive for methamphetamine. I was like, I’m not sure how that’s possible. I mean, I don’t take anything that would come up as methamphetamine. | |
| Shoshana Walter: | Grace was diagnosed with Attention Deficit Disorder when she was 12 years old, so she was on a medication called Vyvanse for her ADHD. | |
| Grace Smith: | And I’m like, well, I take an amphetamine. She’s like, “Well, your urine tests show that you were positive for methamphetamine, and so we’ve had to alert the children’s services who will conduct a,” what was the word they used? They’re going to conduct a? | |
| Michael Smith: | And investigation of your family. | |
| Grace Smith: | Yeah. | |
| Shoshana Walter: | Just like Susan, and like many parents I’ve talked to, Grace and Michael just felt furious that their home and privacy would be invaded over something that they didn’t do. | |
| Grace Smith: | I’m like, I don’t think so. And Michael’s going, “Nope, I’ve got rights. They’re not coming in my house.” The conversation basically went south from there. I went, I don’t trust this hospital anymore. I want to leave. And Michael went, “Yep, I agree.” And I said, we’re withdrawing all consent for treatment for me and for the baby, and we are leaving immediately. | |
| Shoshana Walter: | They both, at this time, thought that the hospital had made up the story about their son having respiratory issues. They were going to bring him to a different hospital for a second opinion. | |
| Grace Smith: | And it got really scary, just so fast. As soon as she left, I was like, I’m going to dress right now. Go get the baby. And he went to the NICU, he gave the baby a kiss. | |
| Michael Smith: | Gave him a kiss on the forehead and I told him I would be right back and I wasn’t. And I hate that. | |
| Shoshana Walter: | He goes downstairs to the car to get the car seat. | |
| Michael Smith: | Pulled the car around to the front, got Grace. Went up two floors to the NICU and found it locked. | |
| Shoshana Walter: | They weren’t allowed back in the NICU to get their son. And then shortly after that, the police arrived. | |
| Grace Smith: | Running out of the elevator into Michael’s face like, okay, so what’s the problem here? | |
| Michael Smith: | To which my response was, that’s exactly what I’m trying to figure out. | |
| Shoshana Walter: | This is all going on in the NICU waiting room where there are other families. | |
| Michael Smith: | So we’ve got a little bit of an audience collected here. | |
| Grace Smith: | And in front of all of these people, the officer goes, “They’re saying that you have tested positive for meth and that you need to leave. You are trespassing, and if you don’t leave, you’re going to be arrested.” | |
| Shoshana Walter: | In the hospital records, the doctor had described Michael as agitated and confrontational. Michael says he was stern. But at this point, he and Grace understood the stakes of being combative. | |
| Grace Smith: | I looked at Michael and I said, Michael, you can’t say anything. You just, please don’t say anything. | |
| Shoshana Walter: | The police escort the parents down the elevator, out through the hospital doors, and then finally, they drive home without their baby. | |
| Grace Smith: | It was a really dark moment. I don’t think I’ve ever felt that low. I didn’t know what to do. I didn’t even know where to start. | |
| Al Letson: | Coming up, Sho figures out, what’s going on with these pee in a cup drug tests. | |
| Shoshana Walter: | Can you list off a few substances that could cause false positives on screens? | |
| Gwen McMillan: | Some common cold medications will trigger positive results. The Sudafed that they’re taking, or the Vicks nasal inhaler. | |
| Al Letson: | That’s next, on Reveal. | |
| Al Letson: | From the Center for Investigative Reporting and PRX, this is Reveal. I’m Al Letson. There are a few reasons hospitals, drug test people who are about to give birth. A big concern for doctors is the health of the baby. Drug use during pregnancy can cause a newborn to go into withdrawal and possibly need medical help. There’s also a concern that a parent who’s using drugs might have trouble keeping their baby safe. A positive drug test is one clue to look closer, but Shoshana Walter, a reporter with the Marshall Project, was hearing from more and more folks who said that they were prevented from caring for their babies because of a drug test. Sho was talking to people whose test results came back positive from meth, opiates, cocaine. But when Sho dug into it, she was able to trace these results to things like poppy seeds or prescribed cold medication. Sho wanted to understand what was going on with these tests, so she started looking at the research. | |
| Shoshana Walter: | I spoke with this one woman who was taking labetalol, one of the most commonly prescribed blood pressure medications to pregnant women, and she told me that she screened positive for meth. So I looked up studies to see if any toxicologist had written about labetalol, and one of those studies was written by Dr. Gwen McMillan. | |
| Gwen, hi, can you hear me? | ||
| Gwen McMillan: | Yes. Good morning. | |
| Shoshana Walter: | Gwen was super helpful in explaining this stuff to me because she is a medical director of a lab that analyzes drug tests, including for mothers who give birth. | |
| Gwen McMillan: | Identifying drug-exposed newborns is I think a really unmet need and is something I’ve focused a fair amount of effort on. And the most common specimen that’s used for testing pregnant people is urine, and it’s probably the least expensive type of testing to do. | |
| Shoshana Walter: | When I first started reporting on this, I knew absolutely nothing about drug testing. I had to take biology twice in high school, so I really wanted to make sure that I understood the basics. | |
| Can you explain how it works? | ||
| Gwen McMillan: | Sure. The most common method is a two-step process, so there’s- | |
| Shoshana Walter: | Gwen basically described how there’s supposed to be this two-step process to drug testing. The first step someone pees in a cup and the urine sample is put through basically this screening instrument. | |
| Gwen McMillan: | Sort of like throwing out a fishing net where you’re trying to find whatever fish or drugs in this case might be in the urine. | |
| Shoshana Walter: | It basically alerts the provider to the possible presence of anything that looks like it could be an illicit drug. | |
| Gwen McMillan: | All of the amphetamine-like fish, all the opioid-like fish, so they don’t really tell you what the fish are, how big the fish are or anything like that. | |
| Shoshana Walter: | Oftentimes what fishing nets end up doing is picking up lots of different kinds of sea creatures. And so when you think about that in terms of drug tests, a lot of substances that look like meth will get caught up in that net even though they’re not actually meth at all. | |
| Gwen McMillan: | It doesn’t tell you what the drug is. | |
| Shoshana Walter: | Can you list off a few substances that could cause false positives on screens? | |
| Gwen McMillan: | Some common cold medications will trigger positive results. The Sudafed that they’re taking or the Vicks Nasal Inhaler. | |
| Shoshana Walter: | Labetalol, the blood pressure medication looks similar to methamphetamine. | |
| Gwen McMillan: | Labetalol metabolites are triggering the test into thinking that fentanyl or methamphetamine are present. | |
| Shoshana Walter: | Vyvanse the medication for attention deficit disorders also looks like meth. There’s a baby soap that is very commonly used in hospital nurseries and that can show up as positive for marijuana when an infant’s urine is tested. | |
| Gwen McMillan: | Codeine and morphine could come from poppy seeds. | |
| Shoshana Walter: | I was really shocked when Gwen told me how high the false positive rates can be on these tests. | |
| Gwen McMillan: | Close to 50% for many drug classes. | |
| Shoshana Walter: | These are the types of drug tests that hospitals routinely rely on to determine whether or not a patient used substances during their pregnancy. And the issue is not that they’re malfunctioning. This is how pee tests work. They cast this wide net. The problem is when hospitals act on these preliminary results. | |
| Gwen McMillan: | Actions should not be taken based on a single drug testing result, period. | |
| Shoshana Walter: | What Gwen said is that there should be a second step, and that’s a more definitive test where a toxicologist looks at the molecules in that sample to determine whether or not they are the illicit substance that the screen identified. | |
| Gwen McMillan: | But really that type of testing is not mandated. It’s not standardized. And so each hospital gets to decide what type of tests they do. | |
| Shoshana Walter: | Many hospitals just don’t do that second, more definitive test. For one, it’s expensive and also they’re just not legally required to do it. Federal law requires states to identify babies that are, “affected by substances” and refer them to child welfare authorities. But when I reviewed every state law and policy, I learned that most states go even further than that. They’re requiring hospitals to take action anytime an infant is simply exposed or even potentially exposed to substances. And the fastest, easiest way to determine exposure is having the mom pee in a cup. | |
| No state requires hospitals to do any follow-up test once they have that initial result. And even when they do that follow-up test, it can take a while for the results to come back, which could mean releasing a baby to a potentially unsafe caregiver. And you have to remember, medical providers are mandatory reporters. They can be criminally charged for failing to report child abuse and neglect. So hospitals are basically erring on the side of caution either because they’re worried about the baby or they’re worried about liability. | ||
| When Grace Smith tested positive for meth at a hospital in Pennsylvania, she and her husband insisted the result was wrong. | ||
| Grace Smith: | I’ve never done anything like that in my life, so it was just unthinkable that it was being thrown as an accusation and by the hospital no less. | |
| Shoshana Walter: | This was a new hospital for Grace and Michael, they had just moved. So when she came in to give birth, she actually gave them a copy of her medical records from her previous provider so they would know what medications she was on. | |
| Grace Smith: | Because they were like, “We’re going to do a drug screen.” They told us at the outset and I was like, “Okay, here’s my medical marijuana card and here’s my prescription for Vyvanse.” | |
| Shoshana Walter: | Her OB had told her it was fine to continue her ADHD meds during pregnancy. So when this new doctor came in saying Grace had tested positive for meth, Michael started urging her to look at Grace’s old records. | |
| Michael Smith: | You have her medical records, you know she’s on Vyvanse. | |
| Shoshana Walter: | Vyvanse is amphetamine, it’s prescribed amphetamine. And when Grace was drug tested by her previous OB who used a more precise test, she tested positive for amphetamine, her prescription medication and negative for methamphetamine. | |
| Michael Smith: | I asked her, “Did you call her OB whose name is right at the top there? It’s been her OB for years.” | |
| Shoshana Walter: | And what was her response to you asking if she’d looked at her records? | |
| Michael Smith: | She didn’t care. She didn’t care. | |
| Shoshana Walter: | In the doctor’s notes, she says that Michael asked why they weren’t consulting the records or contacting medical providers. And in her own notes, she tells the parents, it’s not the hospital’s job to investigate. Their responsibility is to report the case to Monroe County Children and Youth Services. | |
| Grace Smith: | They shouldn’t have a test that doesn’t differentiate between a legal substance and an illegal substance. Period. They shouldn’t use that ever. | |
| Shoshana Walter: | I reached out to St. Luke’s University Health Network and a spokesperson declined to answer questions about Grace and Michael’s case. What he said is that the hospital complies with all the rules and regulations around testing and reporting. In Grace and Michael’s case, a confirmation test could have clarified that she was positive only for her medication, but in other cases, I’ve looked at, confirmation tests are not enough. For example, poppy seeds actually do contain codeine. So when Susan Horton ate that crunchy poppy seed salad, it’s not a surprise that her test was positive and behind the scenes, her doctors and the CPS caseworkers were even talking about the poppy seeds. | |
| Susan Horton: | Can poppy seeds give a dirty drug test? And the answer was yes. | |
| Shoshana Walter: | There is a way to determine whether poppy seeds might’ve caused a positive result, and that is to look in the urine sample for the presence of the compound thebaine. But there’s no indication in the medical records that they did that test or even were aware that it existed. | |
| Susan Horton: | I felt like everyone at the hospital immediately after having the positive drug test was against me. I didn’t feel like any one of them felt like there was a possibility that it could be wrong. | |
| Shoshana Walter: | Susan’s hospital and CPS both declined to say anything about her case specifically. A spokesperson for Kaiser Permanente said that they take their role as mandated reporters very seriously and that they always conduct a, “multifaceted assessment before reporting someone.” An official with CPS told me in general, a positive drug test on its own doesn’t warrant an investigation. She said they need to see an impact to the child. | |
| People are always asking me, how many women are affected by false positive drug tests? How many babies have been removed from their families? I wish I had an answer. There’s no agency that tracks this information and it’s extraordinarily difficult to get medical and child welfare records, which are confidential. What I do know from talking to top experts in this field is that drug testing of pregnant patients is incredibly common due in part to the opioid epidemic, and every year, tens of thousands of babies are reported to Child Protective Services without any guarantee that the underlying test results are accurate. In 2022 alone, more than 35,000 of these cases were reported and authorities removed more than 6,000 infants from their families. | ||
| Grace Smith: | Hi. | |
| Shoshana Walter: | When Grace and Michael told me their story, it was almost three years after Grace had given birth. I visited them at their house in the Poconos in the dead of winter. | |
| Michael Smith: | He’s super friendly. | |
| Shoshana Walter: | Two dogs. | |
| Child: | Daddy. | |
| Shoshana Walter: | Okay, you have to tell me how to play it. | |
| Four kids. | ||
| Michael Smith: | This is the kid himself. This is [inaudible 00:12:02]- | |
| Grace Smith: | Yeah. This is Julian. | |
| Shoshana Walter: | Hi, Julian. | |
| Grace grew up in a big family and both of her parents and her sister have an attention deficit disorder. | ||
| Grace Smith: | My sister was the youngest person in the state to be medicated for it. | |
| Shoshana Walter: | Oh my gosh. How old was she? | |
| Grace Smith: | Three, I think. | |
| Shoshana Walter: | Wow. | |
| Grace Smith: | Yeah, and the CDC wanted to do a family study on our family because we all had it. | |
| Shoshana Walter: | Grace’s mom was actually pretty funny about so many of them having ADHD. | |
| Grace’s mom: | We’re not a very good breeding pair. | |
| Grace Smith: | It was Christmas last year. | |
| Shoshana Walter: | This is the house Grace and Michael came home to after they were kicked out of the hospital without their new baby, Julian, but at the time, it wasn’t all decked out in sort of store furniture and sci-fi books. Instead, there was stuff piled everywhere because they just moved here. | |
| Grace Smith: | When I went into labor, the house was completely … It was still boxed up. We all had our mattresses, but everything was in boxes. | |
| Shoshana Walter: | And they both just felt broken. | |
| Grace Smith: | The next day when we woke up, I would call the hospital every couple of hours and see if he was doing okay and they’d tell me he’s doing okay. He’s taking formula okay. I just remember how hard that hit me. | |
| Shoshana Walter: | Later that day, the hospital tells Grace that she is allowed to come back to the hospital and visit. | |
| Grace Smith: | “You’re allowed to come back in.” | |
| Shoshana Walter: | And Michael is not allowed to come. | |
| Grace Smith: | “But your husband can’t come.” | |
| Shoshana Walter: | He’s still barred from entering the hospital. | |
| Grace Smith: | I was like, “Okay, I’m coming. I’ll be right there.” If he was there for two weeks, I was going to sleep on a chair for freaking two weeks, and that’s what I slept on for the next two nights. | |
| Shoshana Walter: | There’s no privacy. A security guard is posted outside and she’s required to leave the curtain open. | |
| Grace Smith: | It made me feel paranoid and I also couldn’t act like I was paranoid. | |
| Shoshana Walter: | Grace stays in the hospital for a couple days while the hospital is treating her son’s respiratory problem, and while she’s there, a worker from Child Protective Services arrives. | |
| Grace Smith: | The guy who came into the hospital, he couldn’t have been older than 21, 22 tops. It was just, I’m just sitting there having to swallow my pride and going like, this person is about to make a decision based on my kids. | |
| Shoshana Walter: | At the same exact time, a caseworker goes to Grace and Michael’s house to do a home inspection and to interview Michael. | |
| Michael Smith: | He came to the door. He is a big guy. | |
| Shoshana Walter: | Michael’s approach was kind of just to be very amiable. | |
| Michael Smith: | I was really nice to him. | |
| Shoshana Walter: | I reached out to Monroe County Children and Youth Services and they declined to comment, but after those two interviews and the home inspection, the agency notifies the hospital that they can release the baby. | |
| Grace Smith: | Do you remember when I finally got to bring Julian home from the hospital? | |
| Child: | I just remember you got back and you were like, “We have him now” or something. That was the only thing I remember from that day, and you just holding Julian. | |
| Child: | And when we didn’t have him, you and dad were crying. | |
| Shoshana Walter: | Hello, Julian. | |
| During my visit, I gave Julian my headphones so he could hear people talking on the mic. | ||
| Hello? | ||
| Michael Smith: | Hi, Julian. What’s your name? What’s your name? | |
| Julian: | My name is Julian. | |
| Michael Smith: | That’s right. | |
| Grace Smith: | Julian, how old are you? | |
| Child: | We’re old. | |
| Julian: | My name is Julian. | |
| Grace Smith: | Two. | |
| Michael Smith: | He’s in the weeks or two where he is starting to take sentences. It’s the light bulb. | |
| Julian: | [inaudible 00:15:53]. | |
| Al Letson: | Coming up, the long-lasting consequences for new parents who get a false positive result on a drug test. | |
| Shoshana Walter: | Could women be criminally charged over false positive drug test results? They can. | |
| Al Letson: | You’re listening to Reveal. | |
| Al Letson: | From the Center for Investigative Reporting and PRX, this is Reveal. I’m Al Letson. | |
| Dr. Yashica Rob…: | Hello? | |
| Shoshana Walter: | Hey, Dr. Robinson. | |
| Dr. Yashica Rob…: | Hold on one second, I’m not quite finished yet. | |
| Al Letson: | Reporter Shoshana Walter from the Marshall Project spent weeks trying to catch this one doctor out of Alabama for an interview. | |
| Dr. Yashica Rob…: | Okay. Hello. | |
| Shoshana Walter: | Hi. | |
| Al Letson: | In addition to delivering babies and providing care, Dr. Yashica Robinson, an OBGYN, is an outspoken advocate for reproductive rights in Alabama. So the woman’s busy. | |
| Shoshana Walter: | Did you get something to eat? | |
| Dr. Yashica Rob…: | No, no. We was about to run and get something- | |
| Al Letson: | When Sho finally catches her. | |
| Shoshana Walter: | Where are you right now? | |
| Al Letson: | Dr. Robinson’s in a parked car outside her clinic. She needs to grab food, but she takes the call because she says she really wants people to give this issue more attention. | |
| Dr. Yashica Rob…: | People aren’t talking about it enough and sometimes when it happens to you, you’re so embarrassed about it, you’re not going to talk about it. | |
| Al Letson: | When they spoke, as part of an episode, we first aired in 2024, Sho had spent the last year investigating routine drug tests of new mothers. Drug tests that result in false positives as often as 50% for some drugs. Sho wanted to talk to Dr. Robinson because she’s had multiple patients who tested positive for substances that they did not take. | |
| Shoshana Walter: | Just off the top of her head. Dr. Robinson rattled off three separate cases where patients in her practice were reported to Child Protective Services as a result of false positives. She told me in one of them, she figured out that the positive result likely came from a drug the hospital itself had prescribed to her patient. | |
| Dr. Yashica Rob…: | I picked up the phone and made a call back to the social worker and said, “This is what I see and this is where this is coming from.” But nobody had made the connection and of course the patient doesn’t know. | |
| Shoshana Walter: | Oh, my gosh. | |
| Dr. Yashica Rob…: | She didn’t know to speak up and say that’s why this was positive. And what if I hadn’t have slowed down, if I had just said, “Nope, I didn’t give her anything, not my problem,: and kept on moving. | |
| Shoshana Walter: | Alabama is one of several states that routinely prosecute women for taking drugs during their pregnancies. So that means that if you get a false positive drug test, not only could your baby be taken and placed in foster care, but you could potentially be arrested. | |
| Dr. Yashica Rob…: | If the confirmation testing wasn’t done, then how do you ever prove that it was a false positive? So a person can be criminally charged for a false positive. | |
| Shoshana Walter: | Can I ask, what are the reasons these mothers are being tested for drugs in the first place? | |
| Dr. Yashica Rob…: | Some facilities do what they call universal screening. | |
| Shoshana Walter: | Some hospitals drug test every single patient who comes in to give birth. Other hospitals flag patients with certain medical conditions like high blood pressure or bad teeth. And many hospitals have no policies at all, it’s just left up to staff and they may decide just based on how someone looks or acts. | |
| Dr. Yashica Rob…: | Maybe they appear more disheveled or more agitated. | |
| Shoshana Walter: | I heard from doctors that if someone has tattoos, they’re likely to be drug tested or maybe they look homeless, they’re drug tested. | |
| Dr. Yashica Rob…: | And historically, it ends up being women of color, people that come from a lower socioeconomic background. | |
| Shoshana Walter: | Multiple studies have found that Black, Latinx, indigenous women and women on Medicaid are disproportionately drug tested when they go in to give birth. | |
| Dr. Yashica Rob…: | I see myself a lot in the patients that I care for. But I try to also see it from the provider standpoint as well, because many of them feel like they’re just doing their job. I’ve had a nurse to say, “They should just be happy that we’re trying to make sure that they’re safe and their baby’s safe.” And in one sense, I do understand that. But in the other sense from somebody who has never experienced poverty and has never had any interaction with the system, it’s really not that simple. And I’m sorry, I turned my car back on because I just wanted to start moving. | |
| Shoshana Walter: | Okay, no worries. | |
| Dr. Yashica Rob…: | But, thank you so much, I appreciate- | |
| Shoshana Walter: | Dr. Robinson ended up putting me in touch with a patient from her clinic named Melissa Robinson. No relation. | |
| Melissa Robinso…: | I had an eight pound 11 ounce baby. | |
| Shoshana Walter: | Very healthy. | |
| Melissa Robinso…: | Very healthy, very alert. | |
| Shoshana Walter: | Melissa is a school librarian in Huntsville. And when her urine test came back positive for cocaine, the hospital told her she was not allowed to breastfeed her baby while they sent her urine out for confirmation testing. But by the time that second test came back negative, her case had already been referred to Alabama’s Child Protective Services, and so investigators came to her house anyway. And in the moment, Melissa tried to remain calm and composed, but looking back on it now, she told me it bothers her way more than she realized. | |
| Melissa Robinso…: | Having someone come in and turn your water on and off in your home and to open your refrigerator and to make sure that there are diapers and things that you’ve worked so hard to prepare for the coming of your child, that someone would come in and, excuse me, come in and kind disrespect that, I didn’t process it at the time because I just kind of had to keep going. There’s a newborn in my lap, and I just want to make sure everything’s all right for her. | |
| Shoshana Walter: | I reached out to Alabama’s Child Welfare Agency to understand why, despite the negative confirmation test, the agency still investigated Melissa. And a spokesperson told me they have to respond immediately to a hospital report and make safety decisions based on the available information. In the end, they didn’t find anything and Melissa never lost custody of her baby, but the consequences of being accused and investigated are still with her. | |
| Melissa Robinso…: | My space was invaded and I take great pride in who I am as a person, and my morals, and my ethics, and integrity are things that I pride myself in having. And so something like drugs, period, is something that I would never touch, but especially while I’m pregnant. And for somebody not to realize how vulnerable a woman is at that state, it was difficult to navigate after the fact. I didn’t really have postpartum depression, it was more of a postpartum rage. | |
| Shoshana Walter: | Many of the families I’ve talked to have described a much longer lasting set of repercussions than I expected. | |
| Susan Horton: | My husband this morning, because he knew you were coming, he said, “I’m starting to get triggered,” because you put it all to the back of your head, but there are things that bring it up again. | |
| Shoshana Walter: | Susan Horton’s poppy seed salad saga officially ended about two weeks after her daughter was born. | |
| Child: | Daddy. | |
| Susan Horton: | Yeah. Where’s your toys? The baby didn’t get to live at home those first couple of weeks. Thank you. | |
| Shoshana Walter: | Before Susan was allowed to even be alone with her, she had to convince Child Welfare authorities and a juvenile court judge that she wasn’t a danger to her child. Susan remembers her attorney advising her not to bring up the poppy seeds in court. | |
| Susan Horton: | I had receipts that I had bought it from Costco about four or five days before, but he was like, “Do not mention the poppy seed salad because it sounds stupid.” And I realize that, but that is what caused the dirty drug test, so why are we not talking about the poppy seed salad? | |
| Shoshana Walter: | Susan and her husband agreed to more testing and a home inspection, and once that was done, the judge just dismissed the case. But this experience has created an undercurrent of doubt for Susan. | |
| Susan Horton: | We can go outside if you want. | |
| Shoshana Walter: | Susan really believes in teaching her kids to feel comfortable in nature, and so she has them playing outside all the time, helping to plant the garden. | |
| Child: | What’s that? | |
| Susan Horton: | It’s a worm. Should we save the worm? | |
| Child: | Yeah. | |
| Susan Horton: | Yes. This scene right here is like- | |
| Shoshana Walter: | Susan Horton’s mothering strategy. | |
| Susan Horton: | Yeah. Yeah, so she’s got her toes in what was a water hole, now that she is kicking, it’s more of a mud hole. | |
| Shoshana Walter: | She was like splashing in the mud puddle in her bare feet and legs. | |
| Susan Horton: | Just kicking her little toes. | |
| Shoshana Walter: | Susan feels like that’s such an important part of childhood. | |
| Susan Horton: | Gosh, there’s a bug. | |
| Shoshana Walter: | And she said that even in this moment when she and I were talking and watching her daughter delighting in the muddy puddle that she had this fear that passed through her. | |
| Susan Horton: | If anyone knew that she was in a little dirty, watery hole playing, that someone out there would see it as neglect or abuse in some way. | |
| Shoshana Walter: | It’s just undermined her sense of self and confidence as a mother. | |
| Susan Horton: | Momma’s going to get you. Momma’s going to get you. I’m going to get you, get you, get you, get you. | |
| Shoshana Walter: | It took Grace and Michael Smith three days to bring their son Julian back to their home in the Poconos. | |
| Julian: | Diapers. | |
| Michael Smith: | Yep. Diapers, poops. | |
| Shoshana Walter: | But they remained under investigation by Child Protective Services for another month. Like Susan, they spent several thousand dollars on an attorney plus $300 more to pay for their own follow-up drug test. It was Grace’s mom who had the idea of doing a hair follicle test, which can identify specific illicit drugs going back three months. | |
| Grace’s mom: | We knew that we had to get the lie, the initial lie put down before we can make any progress. | |
| Grace Smith: | And as soon as I turned that into them, that was it. | |
| Shoshana Walter: | CPS then closed their case. | |
| Michael Smith: | Very cut and dry, very bureaucratic. | |
| Grace’s mom: | Oh my, gosh. There’s a dog peeking in. You can see just one eye peeking around that door. | |
| Shoshana Walter: | One of the things I found in my reporting that totally blew me away is that there’s a known solution to all of this. There are already laws and regulations for drug testing, just not when it comes to pregnant people. When the Reagan administration started drug testing many workers in the 1980s, those workers were up in arms about false positives. So now there are all these protections. Many workers have the right to confirmation tests. They have the right to a review from a specially trained doctor who talks to them about what they’ve eaten or taken that could have caused a positive result. I actually found this report from the 90s where a federal advisory committee recommended pregnant women get all of those same rights. But that detail buried in that report was basically ignored. | |
| So today, even most child welfare workers have protections in the workplace, but the mothers they’re tasked with investigating have none. Michael and Grace were so incredibly upset by their experience that they spent the entire next year filing their own lawsuit against everyone they thought might’ve been involved. The complaint was almost a thousand pages long and it didn’t get very far. The hospital argued it did not violate Grace’s privacy and civil rights. And the judge eventually dismissed the case saying in part that the Smiths did not sufficiently argue their claims. You could see that as a total failure, but that’s not how Grace’s parents see it. | ||
| Grace’s mom: | They had to do that lawsuit. | |
| Shoshana Walter: | Why? | |
| Grace’s mom: | They could not have lived with themselves if they hadn’t tried. | |
| Grace’s dad: | Just to make sure that this wouldn’t happen again. | |
| Grace’s mom: | You got to try. They wanted justice. | |
| Grace’s dad: | Yeah, they did. | |
| Grace’s mom: | And justice is important to people. When things go wrong, you say, “Well, somebody’s got to do something here.” | |
| Julian: | I did. I did. | |
| Grace’s dad: | It’s the only way we improve. | |
| Al Letson: | After Sho’s stories came out, lawmakers in several states proposed bills that would limit drug testing during childbirth. None of the bills passed, but lawmakers in those states promised to try again. Sho turned some of her reporting for Reveal into a book about the addiction treatment industry. It’s called Rehab: An American Scandal, and it comes out later this month. You can pre-order it wherever books are sold. | |
| Today’s show was reported by Shoshana Walter in collaboration with the Marshall Project. You can read the digital version of Sho’s story with more details about these cases and others on Motherjones.com. | ||
| Our lead producer this week is Marianne McCune. Jenny Casas edited the show. Additional editorial support from Manuel Torres, Nina Martin, and Kate Howard. Special thanks to Marshall Project data reporters, Weihua Li, Andrew Rodriguez Calderon, Nakylah Carter, and researcher Catherine Odom. Nikki Frick is our fact-checker. She had help from Kim Freda. Our legal review is by Leita Walker. Our production manager is the great Zulema Cobb. Score and sound designed by the dynamic duo, Jay Breezy, Mr. Jim Briggs, and Fernando, my man, yo, Arruda. They had help from Claire C-Note Mullen. Taki Telonidis is our deputy executive producer. And our executive producer is Brett Myers. Our theme music is by Comorado Lightning. | ||
| Support for Reveal is provided by the Riva and David Logan Foundation, the John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Robert Wood Johnson Foundation, the Park Foundation, the Schmidt Family Foundation, and the Hellman Foundation. Support for Reveal is also provided by you, our listeners. Reveal is a co-production of the Center for Investigative Reporting and PRX. I’m Al Letson, and remember, there is always more to the story. | ||