greennursevtWorking both in labor and delivery, and more specifically with substance use in pregnancy, the topic of cannabis often comes up.
Both American Academy of Pediatrics and American College of Obstetricians and Gynecologists recommend screening when a pregnant person enters prenatal care.
Urine tests are the most common, but the length of time someone tests positive for THC can vary based on pattern of use. I have seen it last for days in some people, and for months in others.
If there is known prenatal exposure at delivery, whether through screening or verbal admission, the Child Abuse Prevention and Treatment Act (CAPTA) requires hospitals to fill out a Vermont Plan of Safe Care and Notifications.
A few years ago, CAPTA amendments differentiated marijuana from other drug illicit use. The Vermont Department of Children and Families has articulated situations which meets Vermont’s report acceptance criteria regarding prenatal substance exposure as:
“A newborn has a positive toxicology screen for illegal or non‐prescribed substances, other than solely marijuana.”
In addition, “Vermont DCF no longer accepts reports where the sole concern is regarding a pregnant woman’s use of marijuana. Rather, healthcare providers are required to make a notification to DCF unless there are child protection concerns (in which case a report should be made).
This policy change was discussed with medical providers and other stakeholders. While some studies have suggested that prenatal exposure to marijuana may be harmful, there is lack of sufficient evidence to warrant a child protection intervention. It was determined that the appropriate intervention would be the development of a Plan of Safe Care and a notification to DCF.
If hospital staff believe the parent’s use of marijuana is impacting her ability to safely parent the newborn, a report to DCF should be made in any situation where there is belief that a child is at risk of harm.”
It’s important to recognize that notifications CANNOT be made prenatally, but prenatal exposure CAN be reported after delivery. When DCF Deputy Commissioner Karen Shea was asked her thoughts on these changes, she stated, “If the reporter believes cannabis use places children at risk, they would need to report. However, DCF would not accept the report if the only concern was prenatal use of cannabis.”
Some medical professionals worry this no longer allows for an investigation for other concerns such as a lack of supervision. Others see this as a win for cannabis and for parents at large. I see it as Vermont leading the way, and doing it better.