New Report Reveals Pregnant Black Women More Likely than White Women to Be Tested for Drugs Although White Women More Likely to Test Positive

by Xara Aziz

A new report has revealed that hospitals are more likely to administer drug tests to Black women delivering babies than their White counterparts, although Black women were less likely than White women to test positive for drugs.

In the study entitled, “Association of Race With Urine Toxicology Testing Among Pregnant Patients During Labor and Delivery,” researchers analyzed medical records of over 37,000 patients who delivered a baby at healthcare systems across Pennsylvania between March 2018 and June 2021.

The report comes on the heels of nationwide talks about disparities and systemic racism in healthcare systems across the United States, specifically triggered by the Covid-19 pandemic’s lopsided toll on people of color and the recent data highlighting maternal mortality rates among Black and Native American women.

“Any given clinician may not be thinking about bias, but when you look at these kinds of data, you can see there is no other explanation,” said Marian Jarlenski, an associate professor of health policy and management at the University of Pittsburgh School of Public Health author of the report told The New York Times.

Dr. Alison Stuebe, a professor of obstetrics and gynecology at the University of North Carolina further indicated that the findings are clear. “This study is one example of how provider behavior causes Black women to distrust the health care system.”

Researchers of the paper used a control group keeping in mind varying demographic and medical factors and analyzed the likelihood of urine toxicology testing for different groups. They found that although more “Black women had reported prior drug use, mostly of cannabis, the difference did not fully explain the results: Black patients had the highest probability of undergoing urine tests at delivery, regardless of their prior drug use,” The Times report reads. “Among those who did report substance use in the previous year, the likelihood of being tested was 76 percent for Black women, compared with 68 percent for White women.”

However, White women with a history of drug use were more likely to test positive, compared to 58 percent of Black women with such histories.

“It’s not clear what led to greater drug testing of Black women at the Pennsylvania health system, the report added. “All patients entering the labor and delivery department were screened verbally for substance use, with questions adapted from the National Institute on Drug Abuse’s quick verbal screening test.”

The policy called for running urine toxicology tests on patients with “positive test result from the screening test, a history of drug use in the year before delivery, few prenatal visits or a poor birth outcome without a clear medical explanation.”

The report continued: “In addition to calculating probabilities, the study reported the raw number of patients who were tested for drugs. While about 21 percent of Black patients had reported a history of drug or alcohol use, 25 percent underwent urine testing. Most of the Black women had reported cannabis use.”

The report’s authors recommend that hospitals be mindful of drug testing practices in order to address racial biases.

Read the full report here.

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