One State has a provision that specifically allows applications by a relative or an agency for the care or custody of an unborn when the unborn's welfare is in danger and the pregnant mother is in the State at the time of application for services. 12 Until explicit laws are created to deal with the question of reporting substance abuse during pregnancy, professionals will need to continue to infer the answer on the basis of existing State child abuse and neglect reporting laws. An increasing number of States have dealt with the issue of prenatal alcohol and other drug abuse by mandating that substance-affected infants be reported at the time of birth. Some States specifically mention prenatal drug exposure in their statutes defining child abuse and neglect. The condition of the infant that triggers mandatory reporting laws varies from State to State.
Some States require only a positive toxicology screen at birth.
Other States require physical signs of addiction or dependence. Most States, however, have no explicit laws requiring the reporting of prenatal substance exposure. In these States, the determination of whether professionals should report such cases requires a legal analysis of existing child abuse and neglect reporting laws. Variations in Reporting Professionals mandated to report reasonable suspicions of substance abuse that may cause risk to a child sometimes choose not to report. Private physicians, for instance, may not want to risk the loss of paying clients or the control that they maintain over their patients' care.