Acting together, hospital staff and the police department developed a written policy for determining which pregnant women would be screened and, if they tested positive, prosecuted. Women would be selected for urine screening if they met certain criteria, such as prior lack of prenatal care, known history of drug or alcohol abuse, intrauterine fetal death, or abruptio placentae. If the women tested positive, they were referred to substance abuse counseling and threatened with prosecution. The hospital staff acknowledged that the "threat of law enforcement intervention... provided the necessary leverage to make the policy effective." Women who tested positive a second time were arrested, even before giving birth. If the positive test occurred prior to the 28th week of pregnancy, the woman would be charged with simple possession. If she tested positive in the 28th week or later, she would be charged with possession and distribution to a person under age 18—to wit, the fetus. If she delivered the baby "while testing positive for illegal drugs," the woman would also be charged with unlawful neglect of a child.
