Drug test taken without consent nearly cost couple their sons
The birth of Emily and Michael Donlin’s second child did not go as planned.
The labor progressed quickly, and Emily gave birth on the back porch of their home in Des Moines, Iowa, in March 2023. Michael caught the baby, a healthy boy they named Paul.
Emily and Michael were overjoyed and eager to introduce Paul to his brother, Walter, now 2, after an ambulance took Emily to be checked at Broadlawns Medical Center.
But their joy was shattered when they discovered Broadlawns had conducted a drug screening on a portion of the umbilical cord, without the Donlins’ knowledge or consent. It came back positive for cocaine.
The Donlins were reported to Iowa Child Protective Services for child abuse, thrusting them into an eightmonth fight for custody of their sons.
Emily, 31, maintains there was a mistake, saying neither she nor her husband, also 31, has ever used any illicit substances – let alone cocaine. But their protests didn’t matter, they say: The system immediately assumed they were bad parents.
“It changes your whole worldview because you believe you can trust these parties. We trusted that they were going to do what’s right, and that they would see what’s actually going on and that we’re not doing drugs,” Emily said. “But we quickly realized that we actually can’t trust them.”
The Donlins’ ordeal is not unique. Hospitals routinely conduct drug tests on perinatal patients and their newborns. As a result, medical providers are often the leading reporters nationwide of new parents who become involved with child protective services and law enforcement.
Broadlawns declined to comment on the Donlins’ case, citing privacy laws. But hospitals say such policies are necessary for child welfare and to ensure the long-term wellness of parents who may be struggling with substance use.
Yet while providers say they approach testing with compassion, these policies create immense stress for parents, who often face the threat of separation from their children or even criminal charges.
Testing patients if risk factors are identified
Des Moines hospitals say they follow perinatal drug screening guidelines developed by the Iowa Neonatal Quality Collaborative that recommend providers follow a risk-based assessment to decide whether to test. That includes determining whether the patient or the patient’s partner has a past history of using substances, among other factors.
These state guidelines further say all pregnant patients should be assessed for the risk of alcohol and illicit drug use during every prenatal visit and at delivery. Drug testing should be used to confirm suspected use.
Consent is required for screening done on the mother, but not on the newborn, according to Dr. Amy Ferguson, medical director for the newborn nursery at Blank Children’s Hospital in Des Moines.
Testing ensures providers can closely follow young patients who have been exposed to substances, said Jennifer Sleiter, pediatric nurse practitioner at the Drug Endangered Children program at Blank’s STAR Center.
“We know if we monitor these kids and identify any problems early on, we can refer these kids to services so they can stay on track,” she said. “We’re just trying to set them up for success later in life.”
Substance use in pregnancy is classified as child abuse under Iowa law, though it is not considered a crime. Iowa health care workers are required to report suspected cases of child abuse, including instances of drug or alcohol use during pregnancy.
“The state respects the bond between parent and child,” according to guidelines from the Iowa Neonatal Quality Collaborative. “However, the state does assert the right to intervene for the general welfare of the child when there is a clear and present danger.”
Broadlawns officials declined to say what may have triggered the drug test in the Donlins’ case. Emily said she was never told why. She suspects the nature of Paul’s birth may have been a reason.
Michael, who works for a remodeling and construction firm, said they felt betrayed that testing was conducted without their knowledge.
“These doctors don’t realize that even if the kids aren’t taken away, even if the parents are innocent, how it can mess up an entire family,” he said. “They have no understanding of what it does when somebody comes to your door unannounced with the threat of taking away your kids.”
A fight for custody
Two weeks after Paul’s birth, without warning, a caseworker from Iowa Child Protective Services arrived at the Donlins’ door to tell them Emily had been deemed founded for child abuse because of the positive test.
Emily, a stay-at-home parent, is adamant there was a mistake. “I have never taken cocaine in my entire life,” she said. She doesn’t even take ibuprofen for headaches.
Broadlawns declined her request to retest the original sample, she said.
She took seven more drug tests in the following weeks, including a hair test designed to detect illicit substances over a 12-month period. All came back negative, according to documents the Donlins provided to the Register.
A caseworker’s inspection of their home on April 18 and May 1 found no other evidence of drug use, as confirmed by documents provided by the Donlin family to the Register.
Umbilical cord drug tests are “99.9% accurate,” according to Anthony Burriola of Mid-Iowa Occupational Testing. His company conducted the hair test for Emily that came back negative.
However, human error can happen, he said. Though exceedingly rare, it is possible samples from two patients could have been switched by mistake.
“That’s the more likely scenario where you would run into a false positive, rather than a scientific reason with the test,” Burriola said.
Emily and Michael Donlin questioned why they were under such intense scrutiny from state officials. They became frustrated and resisted recommendations that the family undergo intervention services and additional substance-abuse evaluations.
Child Protective Services then escalated the investigation into a Child in Need of Assistance (CINA) case, asking for court intervention to enforce services or make decisions about custody.
In November, the Donlins received a letter saying the state planned to recommend their two sons be placed in foster care.
“It really does change your whole perspective when a government body can accuse you of something that you haven’t done, and they can remove your children,” Emily said.
Iowa Department of Health and Human Services wouldn’t comment on the family’s case, citing privacy laws.
“Ensuring children are safe is the top priority of the Iowa Department of Health and Human Services (HHS), and we take that responsibility very seriously,” according to a statement. “Whenever abuse is suspected, mandatory reporters are required by law to report it to the state and HHS is required to investigate.”
The Donlins’ attorney did not return calls from the Des Moines Register.
In some states, hospital drug screenings lead to criminal arrests
Reports from medical professionals account for one in three cases nationwide that entwine families with child protective services or law enforcement, according to the advocacy group Pregnancy Justice. The vast majority of referrals result from substance use during pregnancy.
Major medical associations strongly oppose criminalizing substance use in pregnancy, noting that doing so often deters patients from seeking care and leads to worse outcomes for parents and children. Des Moines health officials echoed that stance, saying substance use should be treated as a health condition – not a crime.
“We wouldn’t criminalize a parent’s ability to care for their child if they have cancer. We’re not going to do that for a substance use disorder, either,” said Chaney Yeast, director of family services and government relations at Blank Children’s Hospital.
Pregnancy Justice strongly opposes hospital-based drug screenings. “Any positive test could open the door to this scrutiny by child protective services, whether or not it’s an appropriate or legitimate test or a false positive or a real positive,” said Lourdes Rivera, the organization’s president. “People are getting entangled in the system and having their families destroyed and potentially going to jail, so it’s really problematic.”
Though local health care providers say the risk assessments for substance use are crafted to ensure objectivity, Pregnancy Justice research has found these policies are often biased toward people who are low-income and not white.
“Testing and criminalizing people through pregnancy has been a really effective tool of surveilling and punishing poor people and people of color,” Rivera said.
Local health care providers who support drug screening say that it’s necessary, and that there’s a balancing act between supporting struggling families and ensuring the safety of children.
“We want these kids to be able to be with their families,” UnityPoint Health’s Sleiter said. “But there are definitely times when the No. 1 priority is making sure that that child’s in a safe and nurturing environment. Sometimes that does require a placement outside of the home.”
‘ Tormented’ by the investigation
On Nov. 20, the Donlins’ nightmare ended: A county judge dismissed the CINA case. The couple no longer faces the threat of losing custody.
The judge cited a report from the children’s court-appointed guardian ad litem, which indicated that there were no ongoing safety concerns and no other evidence of drug use. The judge said the state hadn’t met the grounds for removing parental custody.
Still, the reverberations remain. Emily will remain on the state’s child abuse registry for five years. She said they’re exploring legal action to remove her name.
Emily said she was “tormented” while the investigation dragged out, and Michael said she was wracked with guilt over its impact on their children. She fears that a wrong move will result in another report to Child Protective Services.
“When you’re accused of something that you haven’t done, it opens up this whole world of possibilities of what could happen to you,” she said.
While the Donlins said they understand the intent behind hospital drug screenings, they believe the practice can cause real, irreversible harm. They question why they faced losing custody of their children when, they said, there was no other evidence of abuse or neglect.
“I can forgive mistakes,” Emily said. “I can forgive a lab if they give me a false positive drug test. I don’t know if I can forgive the nonconsensual drug tests.
“When you’re going to found me for child abuse when I’ve already tested negative on other drug tests, that’s wrong.”