She Ate a Poppy Seed Salad. Child Services Took Her Baby.

Summary

Reveal Podcast Episode Summary Title: She Ate a Poppy Seed Salad. Child Services Took Her Baby
Host: Al Letson
Release Date: August 9, 2025
Produced by: The Center for Investigative Reporting and PRX

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Introduction: The Crisis of False Positive Drug Tests

In this compelling episode of Reveal, host Al Letson delves into the alarming issue of false positive drug tests administered to pregnant women in hospitals. These erroneous results often lead to the unnecessary intervention of Child Protective Services (CPS), resulting in the traumatic separation of mothers from their newborns. Reporter Shoshana Walter, in collaboration with the Marshall Project, uncovers multiple cases where innocent mothers lost custody due to flawed testing procedures.

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Case Study 1: Susan Horton's Ordeal

[01:41 – 05:57]

Susan Horton’s story is a poignant example of the life-altering consequences of false positive drug tests. After a challenging pregnancy during the COVID-19 pandemic, Susan gave birth to her fifth child, Hallie. The immediate aftermath of the birth took a devastating turn when hospital social workers informed her that her urine tested positive for methamphetamine.

• Susan Horton (08:21): "You tested positive for methamphetamine. You can leave, but your baby cannot."

Initially believing she was being mistaken for someone else, Susan struggled to understand how her consumption of a poppy seed salad the night before delivery could trigger such a result. Her attempts to explain were met with disbelief and aggression from the medical staff.

• Shoshana Walter (03:19): "I had no inkling, no idea that we would be fighting for our baby to come home with us."

Despite having a clean record and no illicit drug use, Susan faced the threat of losing her baby. The hospital’s reliance on preliminary drug test results, without confirmatory testing, left her vulnerable to CPS intervention.

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Case Study 2: Grace and Colin Smith’s Battle

[14:53 – 35:52]

Grace and Colin Smith experienced a similar ordeal in Pennsylvania. Grace, a lawyer managing ADHD with prescribed Vyvanse, and Colin, a stay-at-home dad, were preparing for the birth of their fourth child. Upon admission, Grace tested positive for methamphetamine, leading to an immediate CPS investigation.

• Colin Horton (15:50): "We have a right to consent."

Despite presenting medical records that clearly showed Grace’s prescription for Vyvanse, the hospital proceeded with CPS involvement without conducting a second, more accurate test. This oversight resulted in the short-term placement of their newborn in the Neonatal Intensive Care Unit (NICU) and the subsequent loss of custody.

• Michael Smith (18:00): "We were escorted out of the hospital without our baby."

The Smiths' case highlights the failures in the system where confirmatory tests are either not mandated or overlooked, leading to unjustified family separations.

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Expert Insights: Understanding False Positives

[19:15 – 25:06]

To comprehend the technicalities behind these false positives, Shoshana Walter consulted Dr. Gwen McMillan, a medical director specializing in drug testing.

• Dr. Gwen McMillan (19:20): "Some common cold medications will trigger positive results. The Sudafed that they're taking or the Vicks nasal inhaler."

Dr. McMillan explained that the initial urine screening tests are broad and can mistakenly identify substances like poppy seeds or prescribed medications as illicit drugs. For instance, Vyvanse, an ADHD medication, metabolizes similarly to methamphetamine, leading to confusion in the test results.

• Shoshana Walter (22:57): "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 are not actually meth at all."

Despite the availability of more accurate confirmatory tests, such as toxicologist analyses, hospitals often skip these steps due to cost and lack of standardized protocols, exacerbating the problem.

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Systemic Failures and Disproportionate Impact

[25:19 – 40:05]

The absence of mandatory confirmatory testing means that many mothers are wrongly accused based on unreliable initial screenings. This issue is compounded by systemic biases:

• Shoshana Walter (40:05): "Multiple studies have found that Black, Latinx, Indigenous women and women on Medicaid are disproportionately drug tested when they go in to give birth."

These biases result in marginalized communities bearing the brunt of these flawed practices, leading to higher rates of unnecessary CPS interventions among women of color and those from lower socioeconomic backgrounds.

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Long-Term Consequences for Affected Families

[43:42 – 50:05]

The repercussions of false positives extend far beyond temporary custody losses. Families endure emotional trauma, legal battles, and lasting distrust in the healthcare and child welfare systems.

• Susan Horton (45:15): "It undermined my sense of self and confidence as a mother."

Grace and Michael Smith's legal pursuit, though ultimately unsuccessful, underscores the desperate measures families take to reclaim their lives.

• Michael Smith (47:35): "We spent the entire next year filing our own lawsuit against everyone we thought might have been involved."

These stories reveal a deep-seated crisis affecting both individual families and societal trust in medical and legal institutions.

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Potential Solutions and Call for Reform

[50:05 – 52:06]

Despite the existence of protocols for confirmatory testing, they remain underutilized for pregnant women. The episode emphasizes the need for systemic reforms:

• Shoshana Walter (47:28): "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."

Advocacy for standardized confirmatory testing and unbiased screening practices is crucial to prevent further injustices. The episode calls for legislative action to protect mothers from the devastating consequences of false positive drug tests.

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Conclusion: The Urgent Need for Change

Reveal shines a light on a critical flaw in the healthcare and child welfare systems, where innocent mothers are unjustly penalized due to unreliable drug testing. Through harrowing personal stories and expert analysis, the podcast underscores the urgent need for policy reforms to ensure that justice prevails over flawed procedures. As Shoshana Walter poignantly states, "Justice is important to people. You know, when things go wrong, you say, well, somebody's gotta do something here."

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Notable Quotes:

• Susan Horton (08:21): "You tested positive for methamphetamine. You can leave, but your baby cannot."
• Shoshana Walter (22:57): "Oftentimes what fishing nets end up doing is picking up lots of different kinds of sea creatures."
• Michael Smith (18:00): "We were escorted out of the hospital without our baby."
• Dr. Gwen McMillan (19:20): "Some common cold medications will trigger positive results."
• Shoshana Walter (47:28): "There's a known solution to all of this."

---

This episode of Reveal not only exposes the heart-wrenching experiences of affected mothers but also advocates for necessary changes to protect vulnerable families from systemic failures.

Transcript

[Lisa Schachter]

Did you know you have the power to inspire future generations with the same impactful reporting you trust and believe in right now? I'm Lisa Schachter, and I manage the Legacy Society program at the center for Investigative Reporting. When you include Reveal in your will or other legacy plans, you are passing along your values of truth and integrity. It won't cost you anything right now, and you don't need to be wealthy to make a difference. A gift of any size through your will or from your retirement plan, life insurance plan, or other financial account can ensure that Reveal's meaningful, factual reporting continues for decades to come. For more information about making a legacy gift to Reveal or to notify us that you already have, give me a call at 415-321-1706 or send an email to giftsevielnews.org again. That's 415-321-1706 or giftsvealnews. Please consider creating your legacy of truth today. Thank you.

[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.

[Susan Horton]

Says, so I just want you to know that your urine tested positive for drugs.

[Colin Horton]

You tested positive for methamphetamine.

[Susan Horton]

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.

[Colin Horton]

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.

[Susan Horton]

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 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. Show decided to investigate too. This week we're revisiting an episode we aired last fall in partnership with the Marshall Project. Tracking was show 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?

[Grace Smith]

Hello?

[Shoshana Walter]

I'm kind of firing on multiple fronts. Can you hear me? Hi. Hi.

[Grace Smith]

Can't hear you.

[Shoshana Walter]

Say something again. One of the first things I did is I just kind of searched for people making accusations of false positives. He's like, well, your urine tested positive for opiates. I said, that makes no sense.

[Colin Horton]

I've never done drugs in my life.

[Grace Smith]

I wasn't under influence or any drugs. They refused to take a new sample. 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.

[Grace Smith]

They took her. I had to leave the hospital without her.

[Shoshana Walter]

You're not allowed to be with any.

[Colin Horton]

Of your children by yourself for at.

[Shoshana Walter]

Least the next 45 days. I was reading through appellate court rulings and I found cases where women's parental rights were actually terminated.

[Grace Smith]

Do you feel comfortable having your name in the story? 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.

[Colin Horton]

Yeah. Because I get anxious.

[Shoshana Walter]

I also have to ask them to send me their records.

[Grace Smith]

When we get off the phone, I will look for all that stuff. That would be really great to see.

[Shoshana Walter]

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. Like 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.

[Susan Horton]

This is the microphone. I'll meet the microphone. Oh, yes. Hi.

[Shoshana Walter]

I think she was really scared to revisit this experience. So 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 like 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.

[Shoshana Walter]

Looked fine 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, you know, she lacked.

[Shoshana Walter]

Childcare and both her husband and her 16 year old are immunocompromised.

[Susan Horton]

My second born, Liam, was born with a congenital heart defect and had five open heart surger.

[Shoshana Walter]

So Susan basically avoided the doctor during COVID The night before Susan went in.

[Susan Horton]

To give birth, 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 9 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? What?

[Susan Horton]

My urine? Like, you're, 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 what drug came up. The woman says she's positive for opiates. Then later she comes back and says she's positive specifically for coding cough syrup.

[Susan Horton]

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, ding, ding, ding. The pizza and the salad, a poppy seed salad.

[Susan Horton]

It was delicious. You know, 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, like hear it in your ears and stuff. So I vividly remember chomping down on those poppy seeds.

[Shoshana Walter]

After the provider leaves the room, she just does a quick Google search and she realizes, like, that 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 have 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.

[Shoshana Walter]

To happen, 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, like, emotional and I was alone. Like, 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 because I'm losing it. 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 and.

[Susan Horton]

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, like, there was no reason for any of this to be taking 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 her fourth child.

[Colin Horton]

I called Michael, and I was like, okay, my water broke. We gotta go. And then me and Michael went in to have a baby.

[Shoshana Walter]

Everything seemed to be fine.

[Michael Smith]

He grabbed my finger, and I told him that I was gonna love him for the rest of his life.

[Colin Horton]

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 OBGYN started asking Grace and Michael some questions. You know, 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 homeschooling dad who also went to law school. And then finally, the doctor told them.

[Colin Horton]

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.

[Colin Horton]

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 that children's services, who will conduct a. What was the word they use? They're going to conduct a.

[Michael Smith]

An investigation of your family.

[Colin Horton]

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.

[Colin Horton]

I'm like, I don't think so. And I was going, nope, I've got rights. They're not coming to my house.

[Shoshana Walter]

The conversation basically went south from there.

[Colin Horton]

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're 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.

[Colin Horton]

And it got really scary, like, just so fast. As soon as she left, I was like, I'm getting dressed 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.

[Colin Horton]

And I hate that.

[Shoshana Walter]

He goes downstairs to the car to get the car seat, pulled the car.

[Michael Smith]

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.

[Colin Horton]

Arrived, running out of the elevator, like, 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.

[Colin Horton]

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.

[Colin Horton]

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.

[Colin Horton]

It was a really dark moment. Like, 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?

[Dr. 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.

[Colin Horton]

Foreign.

[Shoshana Walter]

Hello, listener. My name is Najeebamini and I am a producer here at Reveal.

[Lisa Schachter]

Reveal is a nonprofit news organization, and we depend on support from our listeners, listeners like you. Donate [e-mail] donate. It helps fund the stories that we tell and helps me find feed my cat.

[Shoshana Walter]

So thank you.

[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. Show was talking to people whose test results came back positive for 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 method. 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.

[Colin Horton]

Gwen, hi.

[Shoshana Walter]

Can you hear me?

[Dr. Gwen McMillan]

Yes.

[Shoshana Walter]

Good morning. 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.

[Dr. Gwen McMillan]

Birth, 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. It's non invasive 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? Sure.

[Dr. Gwen McMillan]

So 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, sort of.

[Dr. Gwen McMillan]

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.

[Dr. Gwen McMillan]

All of the amphetamine like fish, and all the opioid like fish, 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 are not actually meth at all.

[Dr. 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?

[Dr. 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.

[Dr. 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.

[Dr. 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.

[Dr. 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. You know, this is how P tests Work they cast this wide. The problem is, when hospitals act on these preliminary results, actions should not be.

[Dr. Gwen McMillan]

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.

[Dr. 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.

[Colin Horton]

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 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.

[Colin Horton]

Because they were like, you know, we're gonna do a drug screen like they told us at the outset. And I was like, okay, here's my medical marijuana card and here's my prescription for five ants.

[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 obviously, who used a more precise test? She tested positive for amphetamine, her prescription medication, and negative for methamphetamine.

[Michael Smith]

I asked, 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.

[Colin Horton]

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 Grayson Michaels case. What he said is that the hospital complies with all the rules and regulations around testing and reporting. In Grayson Michael's case, a confirmation test could have clarified that she was positive only for her prescription 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 have caused a positive result, and that is to look in the urine sample for the presence of the compound Thebain. 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, quote, 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 confident. 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.

[Colin Horton]

Hi.

[Grace Smith]

Come on.

[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, Daddy. Okay, you have to tell me how to play it. Four kids.

[Michael Smith]

This is the kid himself.

[Shoshana Walter]

This is Julian.

[Colin Horton]

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.

[Colin Horton]

My sister was the youngest person in the state to be medicated for it.

[Shoshana Walter]

Oh, my gosh. How old was she?

[Colin Horton]

Three, I think.

[Shoshana Walter]

Wow. Yeah.

[Colin Horton]

And the CDC wanted to do a family study on our family vacation because we all had it.

[Shoshana Walter]

Grace's mom was actually pretty funny about so many of them having adhd. We're not a very good breeding pair.

[Grace Smith]

It was Christmas last year for Julian.

[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 thrift store furniture and sci fi books. Instead, there was stuff piled everywhere because they just moved here.

[Colin Horton]

When I went into labor, the house was completely. It was still boxed up. We all had our mattresses, but everything.

[Shoshana Walter]

Everything was in boxes, and they both just felt broken.

[Colin Horton]

The next day when we woke up, I would call the hospital every couple hours and see if he was doing okay. And they'd tell me, he's. He's doing okay. He's taking formula. Okay. Now, 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.

[Colin Horton]

You're allowed to come back in, and.

[Shoshana Walter]

Michael is not allowed to come.

[Colin Horton]

But your husband can't come.

[Shoshana Walter]

He's still barred from entering the hospital.

[Colin Horton]

I was like, okay, I'm coming. I'll be right there. If he was there for two weeks, I was gonna 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.

[Colin Horton]

It made me feel paranoid and like 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 sons respiratory problem. And while she's there, a worker from Child Protective Services arrives.

[Colin Horton]

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 like 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's 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 we.

[Colin Horton]

When I finally got to bring Julian home from the hospital, I just remember like you got back and you were.

[Shoshana Walter]

Like, we have him now or something.

[Colin Horton]

That was like the only thing I remember from that day. And you just holding Julian.

[Shoshana Walter]

And when we didn't have him, you.

[Grace Smith]

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?

[Grace Smith]

What?

[Michael Smith]

Hi, Julian. What's your name? What's your name?

[Shoshana Walter]

My name is Julian. That's right, Julian.

[Colin Horton]

How old are you? We're old.

[Grace Smith]

My name is Julian.

[Michael Smith]

He's in the weeks or two where he's starting to take sentences. Oh, it's delightful.

[Al Letson]

Coming up, the long lasting consequences for new parents who get a false positive result on a drug test.

[Grace Smith]

Could women be criminally charged over false positive drug test results? They can.

[Al Letson]

You're listening to Reveal from the center for Investigative Reporting and PRX. This is Reveal. I'm Al Letson.

[Grace Smith]

Hello? Hey, Dr. Robinson. Hold on one second, I'm not quite finishing.

[Al Letson]

Reporter Shoshana Walter from the Marshall Project spent weeks trying to catch this one doctor out of Alabama for an interview.

[Grace Smith]

Okay. Hello.

[Shoshana Walter]

Hi.

[Al Letson]

In addition to delivering babies and providing care, Dr. Yashika Robinson, an OB GYN, is an outspoken advocate for reproductive rights in Alabama. So the woman's busy.

[Grace Smith]

Did you get something to eat? No, no. We was about to run and get.

[Al Letson]

Something when Sho finally catches her.

[Grace Smith]

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 was really wants people to give this issue more attention.

[Grace Smith]

People aren't talking about it enough, and sometimes when it happens to you, you're so embarrassed about it, you know you're not going to talk about it.

[Al Letson]

When they spoke as part of an episode we first aired in 2024, show 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.

[Grace Smith]

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. She didn't know to speak up and say, that's why this was positive. And what if I hadn't 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.

[Grace Smith]

Be arrested 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 false positives. Can I ask what are the reasons these mothers are being tested for drugs in the first place? 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.

[Grace Smith]

Maybe they appear more disheveled or, you know, 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.

[Grace Smith]

Drug tested, and historically it ends up being, you know, 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.

[Grace Smith]

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. Okay, no worries. Thank you. Thank you so much.

[Shoshana Walter]

Dr. Robinson ended up putting me in touch with a patient from her clinic named Melissa Robinson. No relation.

[Grace Smith]

I had an 8 pound 11 ounce bait. Very healthy, 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.

[Grace Smith]

Than she realized having someone come in and turn your water on and off in your home and to open your refrigerator and to make sure that their diapers and, you know, 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 of disrespect that. I didn't process it at the time because I just kind of had to keep going. You know, there's a newborn in my lap, then 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.

[Grace Smith]

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 that I pride myself in having. And so something like drugs, period. 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. 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.

[Grace Smith]

Poppy.

[Shoshana Walter]

Yeah.

[Susan Horton]

Where's your toys?

[Grace Smith]

Hey.

[Shoshana Walter]

The baby didn't get to live at home those first couple weeks.

[Grace Smith]

Please.

[Shoshana Walter]

Thank you. 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 realized 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.

[Susan Horton]

It's a worm. Should we save the worm?

[Shoshana Walter]

Yes.

[Susan Horton]

Yes.

[Shoshana Walter]

This scene right here is like Susan Horton's mothering strategy.

[Susan Horton]

Yeah. Yeah. So she's got her toes in what was a water hole. Now that she's kicking, it's more of a mud hole.

[Shoshana Walter]

She was, like, splashing in the mud puddle on 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]

Like, 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]

Mama's gonna get you.

[Shoshana Walter]

Mama's gonna get you. It took Grace and Michael Smith three days to bring their son Julian back to their home in the Poconos diapers.

[Michael Smith]

Yep, Cypress 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. We knew that we had to get the lie, the initial lie put down before we could make any progress.

[Colin Horton]

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.

[Shoshana Walter]

Oh my gosh, there's a dog peeking in. You see just one eye peeking around that door. 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 have been involved. The complaint was almost 1000 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. They had to do that lawsuit. They could not have lived with themselves if they hadn't tried.

[Al Letson]

Just to make sure that this wouldn't happen again.

[Shoshana Walter]

You gotta try. They wanted justice. Justice is important to people. You know, when things go wrong, you say, well, somebody's gotta do something here.

[Grace Smith]

I did.

[Shoshana Walter]

It's the only way we improve.

[Al Letson]

After show'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. Show turned some of her reporting for Reveal into a book about the addiction treatment industry. It's called 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 Show'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 Hui Hua Lee, Andrew Rodriguez Calderon, Nikhila Carter and researcher Katherine Odom. Nikki Frick is our fact checker. She had help from Kim Frida. Our legal review is by Lita 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 Aruda. They had help from Claire C. Note Mullen. Taki Telenides is our deputy Executive producer and our executive producer is Brett Myers. Our theme music is by Camarado Lightning. Support for reveals 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 Ledsen and remember there is always more to the story.

[Shoshana Walter]

From PRX.