New moms were reported for testing positive for drugs. They had eaten poppy seeds, a lawsuit says.

The morning Crystal H.’s water broke, the medical staff at the Garnet Health Medical Center in Middletown, N.Y., collected a urine sample from her, just as they had during other prenatal appointments, according to a lawsuit filed on her behalf last week. In previous visits, doctors had taken these samples to make sure there was no blood in her urine and to check her protein levels. Crystal, whose last name is redacted in the public filing to protect her privacy, assumed this sample was no different.

But the sample taken on Dec. 18, 2020, was used to screen for drugs — without Crystal’s knowledge and consent, court filings said. The test came back “presumptive positive” for opiates, but not because Crystal had actually consumed any drugs.

She said she had eaten a bagel with poppy seeds, which sometime contain traces of morphine that can trigger a positive result in a drug test.

A mother briefly lost her newborn after failing a drug test. Her doctor suspects poppy seeds.

On Friday, the New York Civil Liberties Union (NYCLU) and National Advocates for Pregnant Women (NAPW) filed human rights complaints on behalf of Crystal and another woman, identified as Jane Doe in the complaint, against the Garnet Health Medical Center. The complaints allege that the hospital drug-tested the women without their knowledge and consent and, after false positives because of poppy seeds, alerted child welfare services.

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Both women claim hospital employees denied them appropriate medical care and bonding time with their children after the false positives, including denying them the chance to breastfeed their children.

“By drug testing me without my consent and reporting a false presumptive positive result to child welfare authorities, Garnet Health turned what should have been the most meaningful moment of my life into the most traumatic one,” Jane Doe said in a news release from the NYCLU. “All because I ate a salad with poppy seed dressing.”

Rob Lee, a spokesman for Garnet Health, said the hospital was unable to comment on the lawsuit.

Yes, you can fail a drug test by eating a poppy seed bagel, as a Maryland mother learned

The allegations are an “extreme example” of what can happen when drug tests go awry, said Donna Lieberman, executive director of the NYCLU. But the cases highlight larger problems with nonconsensual drug screening for pregnant people, which disproportionately affect pregnant people of color and low-income women, advocates say.

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Gabriella Larios, an Equal Justice Works fellow at the NYCLU, said hospital policies around drug screenings for pregnant people are opaque: In many cases, it is not clear whether the hospital screens every pregnant patient for drugs or screenings are done at the discretion of the medical staff. (Garnet did not answer detailed questions about its screening policies.)

“Private hospitals are left to develop their own guidelines,” Larios said. These are guidelines that many patients may be unaware of and that may not be applied uniformly, she added.

Allegations of drug use among pregnant people began taking off during the “crack epidemic” in the 1980s and ’90s, when some politicians and news media helped to fuel fear that the predominantly Black children of cocaine-addicted mothers would develop into criminals.

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To this day, Black and Hispanic parents are disproportionately surveilled for drug use, Lieberman said, including by medical providers. “It’s medical racism,” she said.

Knowing the precise effects of cocaine, marijuana and opiates on pregnant people and infants is challenging, some doctors say.

In an article for Oregon-based Samaritan Health Services from 2020, Lindsey Felix, a neuropsychologist who works for the care network, said recent literature suggests that cocaine, marijuana and opiates have long-term negative consequences. But because it is difficult to gather reliable information about illicit drug use during pregnancy, the effects of those drugs are hard to study.

“Children who are exposed to one substance are often exposed to multiple substances,” Felix said. And people who use these substances also have other risk factors, including low socioeconomic status and poor prenatal care.

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Some studies have found marijuana use can affect the developing fetus’s brain and is linked to lower birth weight, and others have found that opium use can also lead to adverse outcomes. The Centers for Disease Control and Prevention recommends against using marijuana during pregnancy, because it “may increase your baby’s risk of developmental problems.”

Testing for these substances in pregnant people is “controversial,” the American College of Obstetrics and Gynecology notes, and the group recommends that urine drug screening be performed only with the patient’s consent.

The ACOG guidance recommends that “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.”

Policies that deny pregnant people care and access to their newborn because of positive drug tests also contradict current medical guidance, said Emma Roth, a staff attorney at the NAPW who is representing Doe in the recent lawsuit.

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According to Doe’s lawsuit, she was told by a nurse that she could not breastfeed her child, because of her presumptive positive drug test. A pediatrician later intervened, the filing said, advising that even if Doe had consumed drugs and her baby displayed symptoms of withdrawal — which was not the case — breastfeeding would “help to lessen the effects.”

Roth pointed to research that has shown that “rooming in,” the practice of caring for the parent and newborn together in the same room immediately from birth, is “both safe and beneficial for substance-exposed babies.”

Arguments for separation “are really grounded in stigma and ignore a lot of the science around prenatal drug exposure,” Roth said. “A drug test is simply not a parenting test.”

In her complaint, Crystal, who identifies as Latinx, said a mostly White nursing staff have her “accusatory and dismissive treatment” after her presumptive positive result, “ignoring her repeated requests to make the experience of laboring more comfortable.”

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She said that she also was denied the chance to breastfeed and that a nurse did not support the first-time mother as she tried to get her baby to latch to her breast. Two days after giving birth, she was given an electric pump and a lactation consultant, but by that time her infant could not latch, the complaint said. Crystal was never able to breastfeed her child, the complaint said.

There have been similar lawsuits in other states: One Maryland mother faced what she called a “traumatizing” investigation in 2018 when a hospital reported a false positive after she ate poppy seeds. In Pennsylvania, two lawsuits were settled against Lawrence County after officials removed newborn children from their mothers’ care because of failed drug tests. Both women said they ingested poppy seeds shortly before being screened.

Responding to criticism that drug testing policies for pregnant people are racially biased and medically unnecessary, New York City announced last year that its public hospitals would end the practice of drug-testing pregnant patients without explicit written consent.

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The announcement came as the city’s Commission on Human Rights opened an investigation of three private hospitals to determine whether race was a factor in who was tested and reported to child welfare authorities, the Gothamist reported.

Black and Latino children in New York City made up 87 percent of reports of child neglect or abuse, even though they represent only 23 percent and 36 percent of the child population, the outlet wrote. It also reported that in 2019, 760 newborns with positive toxicology tests were reported to child welfare authorities. After an initial investigation, the city found 486 of those cases to be credible.

But without a statewide law barring nonconsensual drug screening, the practice can continue in hospitals such as the Garnet Health Medical Center, 70 miles north of the city, Larios said.

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Lieberman said it was “hypocritical” to continue to enforce secretive drug screening policies while substances such as marijuana are being increasingly decriminalized throughout the country.

Even as drugs are decriminalized, Lieberman said, pregnant people remain “one of the most stigmatized groups in the country” when it comes to drug use. This hampers their ability to get the medical support they need, she said.

Roth added that while NAPW is “incredibly supportive of the efforts to provide resources and access to care to individuals who use drugs,” the “risk of being penalized” is too high. “Our issue here is with this punitive response,” she said.

These policies could also weaken women’s trust in the medical system, causing them to turn away from necessary medical interventions outside of pregnancy, women’s advocates said.

Roth said her client was so traumatized by the experience at Garnet that she refused to seek therapy. “She lost all faith in medical providers to respect her privacy, to keep her records confidential and to be there as a source of support for her and her infant.”

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