When you’re expecting, every decision feels larger than life. Add substance use into the mix and the stakes can feel terrifying. This page breaks down pregnancy addiction and custody in plain English—what hospitals look for, how CPS gets involved, and how to protect parent rights during pregnancy and CPS so you and your baby get the safest start possible. Here’s the hard truth: infants are the most likely age group to enter foster care, and parental substance use is cited in roughly a third of removals in many states. That’s serious—but knowledge, treatment, and a plan can change the story. As Maya Angelou said, “Do the best you can until you know better. Then when you know better, do better.”
Navigating This Guide
This hub page serves as the entry point for deeper exploration. Use the links below to dive into specific areas of Special Situations & Family Roles:
- CPS and Addiction
- Treatment & Recovery
- Outcomes & Appeals
- CPS Basics & Parent Guide
- Family Roles
- Stories, Media & Community
- Legal Guides
- Practical Tools
- Court-ordered
Sub-Menu
- Newborns & CPS: Hospital Notifications, Plans of Safe Care
- Mothers in Recovery: Postpartum, MAT, and Visitation
- Pregnancy, Addiction & Custody: What to Expect
- Grandparents & Relatives: Becoming a Kinship Caregiver
- Immigrant Families & CPS: Language Access, Cultural Considerations
- Fathers in CPS Cases: Rights, Paternity, Reunification Paths
- Domestic Violence + SUD: Safety Plans that Courts Respect
Pregnancy, Addiction & Custody: Parent Rights During Pregnancy and CPS
What triggers hospital reporting? Hospitals are mandated to protect newborns. If screens or clinical signs suggest prenatal exposure—or if there are safety concerns like unstable housing, intimate partner violence, or untreated mental health conditions—the care team may notify CPS. In some states, notification can occur without a formal abuse or neglect finding; it’s often a safety alert so supports can be put in place.
Key points to remember
- A notification is not the same as removal. It starts a review of immediate safety.
- Many families go home together with a documented Plan of Safe Care (POSC) and close follow-up.
- Early engagement in prenatal care and substance-use treatment strongly improves outcomes.
Why the data matters
- National analyses show newborn drug withdrawal (NAS/NOWS) rose dramatically over the 2000s, with estimates around one affected birth about every 15 minutes in 2014—highlighting why hospitals screen and coordinate care.
- Infants under one have the highest foster care entry rate; early treatment and clear discharge plans reduce risk.
What to Expect at the Hospital (Before and After Birth)
Screening & testing. Depending on symptoms, history, or state policy, your OB or hospital may conduct verbal screenings, urine/tox screens, or cord/meconium testing. Ask:
- What test is being used?
- How will results be interpreted?
- Who sees the results and how are they stored?
Care conferences. Social work, nursing, pediatrics, and your OB may invite you to a brief planning meeting. Bring:
- Proof of prenatal appointments and any treatment enrollment
- Medication lists (including medication-assisted treatment)
- Names/numbers of your therapist, recovery coach, or peer support
- A proposed backup sober caregiver for the first weeks at home
Discharge planning. Before leaving, request a written Plan of Safe Care that lists pediatric follow-up, safe-sleep setup, feeding supports, parental treatment appointments, transportation help, and home visiting if available. The POSC is a roadmap for baby and family—not a punishment—and following it can reduce the need for intrusive interventions.
Your Rights & Smart Moves (Step-by-Step)
You have rights during pregnancy and after delivery. Use them—and show you’re actively building safety.
Your rights
- Ask questions about tests, documentation, and next steps.
- Invite your providers (OB, addiction medicine, therapist) to care meetings.
- Request a patient advocate or hospital social worker.
- Seek legal counsel if you need help understanding state-specific rules.
- Access treatment without delay; pregnancy often qualifies you for priority services.
Smart moves right now
- Get into prenatal care and keep every appointment.
- Start or continue treatment (MAT for opioid use disorder, counseling, peer support).
- Write a safety plan: Who helps at night? Who can drive you? Where will the baby sleep?
- Document your effort: save appointment cards, therapy attendance, recovery logs, and medication instructions.
- Line up resources: home visiting, lactation support, WIC, and local parenting programs.
Signs of progress that matter to decision-makers
- Consistent prenatal and pediatric follow-up
- Negative or improving screens when clinically appropriate
- Stable housing and a realistic caregiving schedule
- Verified attendance in treatment and support groups
Featured Video: True Stories of Addiction
Having a history of drug abuse and trauma, he began to act out and experiment with drugs. To fit in, he tried heroin and he began using drug regularly. After years of abuse he tries rehab and puts his hands in a higher power. After 45 days of treatment, he decided to stay the full 90 days. With years of sobriety, he is finally happy with his life.“From fear to follow-through: How one mom worked with her hospital team, created a Plan of Safe Care, and kept her family together.”
Getting Help: Treatment, Legal Guidance & Community Supports
Treatment works. Medication-assisted treatment for opioid use disorder, therapy for co-occurring mental health needs, and peer recovery coaching can stabilize families quickly. Many programs have specialized tracks for pregnant and postpartum parents.
Build your support circle
- Medical: OB, pediatrician, and (if needed) addiction medicine specialist
- Behavioral health: therapist, group counseling, peer support
- Practical aids: home-visiting nurse, lactation consultant, childcare help, transportation
- Legal: consult early if you have questions about CPS procedures or court timelines
How we can help
- Search our treatment directory for programs experienced with pregnancy and postpartum care.
- Call our helpline for a warm handoff to providers who understand POSC and hospital-CPS coordination.
- Download a POSC checklist (if available on your hub) to bring to your next appointment.
Pregnancy addiction and custody concerns are real, but they’re not the end of your story. When you know your parent rights during pregnancy and CPS, engage in treatment, and leave the hospital with a solid Plan of Safe Care, many families stay together and thrive. Your baby needs you—and you deserve a clear path to a safe, healthy start.
