Substance Use Disorder in Pregnancy

ACOG joins every leading medical and public health organization in approaching the problem of drug and alcohol use during pregnancy as a health concern that’s best addressed through education, prevention and community-based treatment, not through punitive drug testing and reporting laws or criminal prosecution.

Research shows that obtaining prenatal care, staying connected to the health care system, and being able to speak openly with a physician about drug problems helps improve birth outcomes.

Our Position

At the federal and state levels, ACOG supports policy prescriptions that prioritize a healthy outcome for both mother and baby including:

• Expanding Medicaid coverage from 60 days to one year after delivery, including for SUD and mental health screening and treatment and case management and outreach services
• Access to medically-assisted treatment (opioid agonist pharmacotherapy)
• Adequate postpartum psychosocial support services including SUD treatment and relapse prevention programs
• Safe prescribing practices
• An increased focus on curbing alcohol and tobacco use during pregnancy

Routine urine drug screening is controversial. ACOG recommends testing be performed only with the patient’s consent and a positive test not be a deterrent to care, a disqualifier for coverage under publicly-funded programs, or the sole factor in determining family separation.

ACOG calls on federal and state legislators to look to science-based guidelines and decades of medical evidence to craft appropriate public health interventions that will optimize health outcomes for moms and babies.