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A Boston, Massachusetts, hospital announced Tuesday that after finding Black mothers were more likely to be reported for child abuse and neglect if a toxicology report came back positive, it would be taking steps to reevaluate the process in order to avoid perpetuating “structural racism.”
“Black pregnant people are more likely to be drug tested and to be reported to child welfare systems than white pregnant people,” said Mass General Brigham, a nonprofit health care system.
“As a part of our United Against Racism effort to achieve health equity for patients and communities across our system, we… are addressing policies that may unwittingly perpetuate structural racism,” Mass General stated.
Below are more excerpts from the hospital’s stunning press release:
Substance use disorder (SUD) is a condition with significant racial and ethnic inequities, especially in the context of pregnancy, when more punitive approaches to substance use disproportionately affect Black individuals. Studies — including some within our system — have found that Black pregnant people are more likely to be drug tested and to be reported to child welfare systems than white pregnant people.
One way that Mass General Brigham is addressing inequities in SUD is by creating a systemwide policy to support pregnant people and their infants to ensure a standardized and equitable approach to toxicology testing and reporting for pregnant people and their infants, aligned with national practice guidelines. The goal is to reduce barriers to treatment that have disproportionately impacted patients of color, while prioritizing practices that support the safety and wellbeing of families impacted by SUD.
“Our new perinatal testing and reporting policy is the latest step in our efforts to address longstanding inequities in substance use disorder care and to provide compassionate, evidence-based support to families, while addressing substance use disorder as a treatable health condition,” said Sarah Wakeman, MD, senior medical director for Substance Use Disorder, Mass General Brigham. “This policy reflects an emerging consensus, based on sound science, that is being embraced by our peer institutions and was developed in coordination with a wide range of partners.”
According to Dr. Wakeman, several values emerged from that report, notably the assertion that having substance use disorder during pregnancy is not, by itself, child abuse or neglect. Further, the report underscored that pregnant people who have SUD should be encouraged to access support and care systems, and that barriers to access should be addressed, mitigated, and eliminated where possible.
One important way to achieve this is to update policies that automatically trigger mandatory filings with child welfare agencies when a pregnant individual is engaged in treatment for substance use disorder, absent any other concerns for potential abuse or neglect. Health equity leaders note that these policies create undue risk that pregnant people might be separated from their newborn infants and discourage them from accessing treatment. These policies disproportionately impact patients from historically marginalized populations.
The policy also notes that an abuse/neglect report to state child welfare agencies in Massachusetts and New Hampshire after delivery should be filed only if there is reasonable cause to believe that the infant is suffering or at imminent risk of suffering physical or emotional injury and that ‘substance exposure’ alone, including treatment with methadone or buprenorphine for opioid use disorder, does not require a report of abuse or neglect in the absence of protective concerns for the infant.
Clinical leaders say the new policy will help reduce stigma and improve access to SUD treatment and support the safety and well-being of families.
Boston hospital to scale back on child abuse and neglect reports that can perpetuate ‘structural racism’ https://t.co/dXlh9gVcAB
— Fox News (@FoxNews) April 4, 2024
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