Reimagining Supportive Approaches at the Intersection of Mandatory Reporting Policies for the Mother–Infant Dyad Affected by Substance Use

Background: As rates of substance use during pregnancy persist, the health and optimal development of infants with prenatal substance exposure remain a key priority. Nurses are tasked with identifying and reporting suspected cases of child maltreatment, including abuse and neglect, which is often assumed to be synonymous with substance use during pregnancy. While policies aimed at protecting infants from child abuse and neglect are well intentioned, literature regarding the short- and long-term social and legal implications of mandatory reporting policies is emerging. Purpose: In this article, we explore the intersections between the condition of substance use in pregnancy and policies related to mandatory reporting. Methods: We provide an overview of historical and current trends in mandatory reporting policies for nurses related to substance use in pregnancy and related ethical and social implications for mother–infant dyads. Results: Nurses often function at the intersection of healthcare and social services, underscoring the important role they play in advocating for ethical and equitable care for both members of the mother–infant dyad affected by substance use. Implications for Practice and Research: We offer recommendations for practice including the integration of respectful care and family-centered support for the mother–infant dyad affected by substance use. Cross-sectoral collaborations, inclusive of the family, are important to the advancement of evidence-based and equity-focused research, advocacy, and policy initiatives to support familial preservation and reduce mother–infant separation.