Babies at Risk Deserve Drug Test

About 700 babies in San Diego County were referred to Child Protective Services last year because they were born with drugs in their systems.

Most were born to women who had had no prenatal care, women who first saw a doctor when they were in labor. Many hospitals check these women for drugs when they perform other routine blood tests so that the delivering doctor knows what risks the baby faces.

Some mothers and attorneys have questioned this policy because the women are not always informed of the tests and because the results might mean the baby will be placed in a foster home. This controversy over testing, however, masks the real culprit: the shortage of prenatal care and drug treatment for the poor.

Out of 8,000 women who need low-cost prenatal care each year in San Diego County, about 5,000 are turned away. Only 14 obstetricians are willing to see Medi-Cal patients because the state reimburses them only $657, while it costs the physician $1,200 to $1,300 to provide the care.

Doctors say prenatal care would avoid much of the need for last-minute drug testing because the woman’s physician is likely to recognize symptoms of drug use earlier in the pregnancy and either convince the prospective mother to stop or to seek treatment for drug abuse.

The latter presents another problem, however. There is a waiting list for most county-funded, long-term treatment programs for drug and alcohol abuse, and only two accept women with their babies.

But, at the very least, the doctors would know before delivery one of the major risks the baby faces.

Children whose mothers did not receive medical care during pregnancy are at risk in many ways. Studies have found that they are more than three times more likely to die before their first birthday than those with prenatal care. They are also 2 1/2 times more likely to need intensive care, which can run more than $30,000 for a three-week stay, compared to about $1,500 for prenatal care.

Most of the solution, however, rests with the state. The county contributes nothing to prenatal care. While other counties have picked up some of the slack in state funding, it is particularly difficult for San Diego County, which has sued the state because it receives less per capita in state funds than almost all other counties.

But, while the financing battle is fought in court and in the Legislature, it makes little sense to exacerbate the problem with a debate over drug testing. Doctors need that information for both the mother’s and the baby’s health.