When a baby is born, the delivery room should be filled with relief and joy—not fear. Yet newborns and CPS hospital notifications can turn a tender moment into a crisis, especially when substance exposure is suspected. Here’s the hard truth: in the U.S., roughly 7 out of every 1,000 hospital births involve neonatal withdrawal symptoms, and infants under one are the most likely age group to enter foster care. That’s a wake-up call for all of us. As Frederick Douglass warned, “It is easier to build strong children than to repair broken men.” This page explains what triggers hospital notifications, how Plans of Safe Care for substance-exposed infants work, and how families can protect their rights while getting help fast.
Why Hospitals Notify CPS About Newborns
Hospitals are mandated to protect infants. If a baby shows signs of withdrawal, has a positive toxicology, or there are credible concerns about caregiver capacity (substance use disorder, untreated mental health conditions, unsafe housing, or domestic violence), the care team may notify CPS. Some states require notification without a formal “abuse/neglect” finding—meaning a report can be filed even when parents are engaged and trying to do the right thing.
Common triggers for notification
- Positive toxicology for the newborn or birthing parent
- Clinical signs of neonatal withdrawal (e.g., tremors, irritability, feeding difficulty)
- Documented substance use disorder without treatment plan
- Prior CPS history involving safety concerns
- Unsafe discharge plan (no stable housing, impaired caregiver, lack of follow-up care)
What the data suggests
- Substance exposure at birth is a significant driver of hospital reporting and case openings.
- Infants account for a disproportionate share of child welfare entries, often tied to safety or caregiving capacity concerns.
- Hospitals report that early care coordination reduces readmissions and improves parent engagement after discharge.
Plans of Safe Care for Substance-Exposed Infants
A Plan of Safe Care (POSC) is not a punishment—it’s a roadmap. It links the baby and the family to the services needed for a safe discharge and stable home life. The goal is to keep families together whenever safely possible while addressing real health and safety needs.
What a POSC usually includes
- Pediatric follow-up: developmental screening, feeding support, and safe-sleep guidance
- Maternal/parental treatment: medication-assisted treatment when indicated, counseling, peer support
- Practical supports: lactation help, transportation, home visiting, parenting education
- Safety steps: safe-sleep setup, sober caregiver availability, naloxone education when relevant
- Check-ins: coordinated follow-up with community providers and, in some cases, CPS
Key point: A POSC is separate from a CPS determination of abuse or neglect. In many states, creating and following a Plan of Safe Care can reduce the need for intrusive interventions because the hospital and family document a concrete path to safety.
What Parents Can Expect at the Hospital
Toxicology and screening. Depending on symptoms, history, or state policy, hospitals may order toxicology for parent and/or newborn. You can ask: What test is being used? How will results be interpreted? Who sees them?
Care conferences. Many hospitals invite parents to a brief planning meeting with social work, nursing, and pediatrics to build the POSC. Arrive with names of your treatment providers, proof of appointments, and any recovery plan you already follow.
Your rights—plainly stated
- You can ask questions and request a patient advocate or social worker.
- You can request that your treatment providers (OB, addiction medicine, therapist) participate.
- You can document sobriety supports: meeting logs, prescriptions, therapy attendance, recovery coach contacts.
- You can seek legal counsel—early legal advice can clarify state-specific rules without escalating conflict.
Discharge planning. Before going home, make sure you have:
- Written Plan of Safe Care with contact info and dates
- Newborn care instructions (feeding, safe sleep) and pediatric follow-up appointment
- Your own follow-up schedule (treatment, therapy, medication management)
- A named backup sober caregiver if you become ill or overwhelmed
Safety note: Babies with withdrawal or feeding issues sometimes stay longer for observation. A longer stay does not automatically mean CPS removal—it often means the team is stabilizing the baby and setting you up for success.
Watch: True Stories of Addiction (Featured Video)
“From fear to follow-through: How one mom worked with her hospital team, created a Plan of Safe Care, and brought her baby home safely.”
Jayson was an athlete who experimented with drugs since he was young. After struggling with his relationship with his wife and children, Jayson’s alcohol and drug addiction began to spiral out of control. Once he started doing meth his life took a different direction. Find out what he did to prevail through the chaos.
Build Your Support Team
Treatment & recovery. If you’re pregnant or parenting a newborn and using substances, evidence-based treatment works. Medication-assisted treatment for opioid use disorder, therapy for co-occurring conditions, and peer support can stabilize families fast.
Practical steps today
- Call your OB/pediatrician and ask for a same-week appointment.
- Contact a local addiction treatment provider that serves pregnant/postpartum parents.
- Line up home-visiting or community nursing for extra support.
- Create a written caregiving plan (who helps at night, rides to appointments, safe sleep).
We can connect you. Search our treatment directory or call our helpline to find trusted programs that understand pregnancy, postpartum recovery, and Plans of Safe Care for substance-exposed infants. The sooner you reach out, the more choices you’ll have—and the more confident you’ll feel when the hospital team starts talking about safety and discharge.
Newborns and CPS hospital notifications are scary, but they don’t have to end in separation. With a clear Plan of Safe Care, collaborative providers, and early treatment, many families stay together and thrive. Your baby needs you—and you deserve real support to make home safe and healthy from day one.
