Personal question for OB nurses in TN

[HippieHealer]

Hey all,

I'm a med-surg nurse and was hoping some of you could help me with a family crisis.

Long story short, we just found out my husband's sister is pregnant with baby #3. This is not good news. The older 2 are being raised by my husband's parents because she's a drug addict/sociopath/trainwreck. Baby #2 was born with tetrology of Fallot and she later admitted to drinking/doing drugs while pregnant (which I believe is what caused this). When the baby finally went home (with her) at 2 months old, he ended up back in the ICU not 2 weeks later with dehydration (my MIL happened to visit them that day and convinced her to take him to the ER as SIL didn't even recognize that anything was wrong when his lips were chapped and his fontanel was sunken in). 2 days later he's back in the ICU with the same thing, so DCS finally gets involved at this point and he gets taken away.

Now, given her history of near-fatal child neglect and substance abuse during pregnancy, I am extremely concerned about this baby going home with her from the hospital. In TN, even if you have other children in state custody, you can still go home with any subsequent children until proven to be unfit (which is infuriating to me, but I digress). I live in NC, and I remember from my Maternity clinicals in nursing school that I had a pt that admitted to drug use during pregnancy. They tested the baby's urine, which came out negative, so nothing was done.

There's no way SIL would ever admit to a dr or nurse that she's using or drinking, so I have every intention of doing what it takes to prevent her from walking out of that hosp with her baby.

So, my Q is, if I call the hospital when she goes into labor and ask to speak to her nurse (which people do on my unit all the time), and let them know that I'm worried about the baby going into withdrawls (which would be pertinent medical information for them to be aware of, IMO), would that automatically warrant them to test the baby and/or her for drugs?

Also, how often do they test meconium vs urine? I know meconium testing is more expensive, but I'd really like it done over urine since it goes back much farther. And if baby and/or mom tests positive for drugs, are they automatically prevented from taking baby home pending a social worker consult, or what happens then? I know I can call DCS anonymously after they're discharged, but I'm trying to prevent that from happening. I want as much evidence against her as possible. If anyone could enlighten me as to protocol in TN hospitals regarding these situations, I would be very appreciative!

[klone, MSN, RN]

I'm not a TN nurse, but I can tell you that they almost always test meconium, because meconium can tell the story of drug use over several weeks, rather than just the last few days.