To describe drug testing practices used in labor and delivery units in seven southeastern U.S. states (Alabama, Georgia, Florida, Mississippi, North Carolina, South Carolina, and Tennessee), determine what risk factors prompt drug testing, and determine whether selective policies or factors that prompt testing differ based on hospital characteristics (type, size, or predominant payer source).

Cross-sectional descriptive design.

Labor and delivery units in seven southeastern U.S. states.

Nurse administrators of labor and delivery units (N = 49) who responded for their units.

We used a purposive sampling technique to construct a database of hospitals with obstetric services and e-mail addresses for nurse administrators. We created a 35-item survey to collect hospital characteristics and drug testing policy information. We distributed the survey to 291 nurse administrators.

We received 49 responses (response rate = 16.8%). Respondents reported that 63% (31/49) of hospitals were not-for-profit, 87% (40/46) had Medicaid as the predominant payer source, 80% (37/46) had a formal perinatal drug testing policy, and 61% (30/49) used selective drug testing protocols. Current or past history of substance use was reported as the risk factor that most often prompted drug testing. We did not find any differences in hospital characteristics (type, size, or predominant payer source) that prompted testing.

Most respondents reported that their labor and delivery units had a written drug testing policy and often used selective drug testing protocols. Drug testing protocols did not differ based on hospital type, size, or predominant payer source. Nurses have a role in implementing a best practice with unit-based drug testing.