Wisconsin hospitals now have access to a new one-page resource, Substance Use Disorder in Pregnancy and Newborns: Screening and Reporting Guidelines for Wisconsin Hospitals, created to support equitable, trauma-informed care for pregnant people and infants affected by substance use. Untreated or under-treated SUD can pose serious health risks, and leading national organizations; including AAP, ACOG, ACNM, AWHONN, and SMFM, emphasize that care should be non-punitive, evidence-based, and built on dignity.
The resource outlines best practices for universal verbal screening, which is the standard of care recommended by ACOG. Tools such as 4Ps Plus, NIDA Quick Screen, and SURP-P are included, along with guidance on how to conduct screening in a supportive way that normalizes the process and avoids stigmatizing language. It also addresses equity concerns, noting that people of color are disproportionately screened and tested, and encourages hospitals to use universal protocols and routinely audit patterns for bias.
The one-pager further clarifies when biological testing is appropriate. Toxicology testing should never replace verbal screening and should only be done when clinically indicated. Because testing can have legal implications and is prone to misinterpretation or false positives, informed consent and clear communication with patients are essential.
The guidance stresses the importance of transparent, compassionate communication with families. Hospitals are encouraged to avoid blame-focused language, acknowledge fears around child welfare involvement, and frame referrals to services as supportive rather than punitive. Plain-language handouts and trauma-informed communication help build trust and keep families engaged in care.
The resource also summarizes Wisconsin’s reporting laws. Wis. Stat. § 48.981 requires reporting to CPS when an infant is affected by prenatal substance exposure and there is risk of harm, while Wis. Stat. § 146.0255 requires informed consent for toxicology testing during pregnancy and notification that positive results may be reportable. The document highlights that punitive approaches often deter prenatal care and worsen outcomes, while supportive services (like home visiting, early intervention, and substance use treatment) strengthen families and improve health.
This new one-pager is designed for quick reference and easy sharing across hospital teams. It can support policy updates, staff training, and consistent, equitable practice across perinatal care settings.
