CUSTODY OF COCAINE-EXPOSED NEWBORNS - DETERMINANTS OF DISCHARGE DECISIONS

Objectives. Maternal cocaine use is a leading grounds for newborn fost er placement. This study was initiated to investigate the factors that predict custody status of infants born to substance-abusing women. Me thods. A retrospective cohort design was used to study the correlates of discharge custody decisions for 99 consecutive infants testing posi tive for cocaine in a public hospital. Results. The population was 49% Black, 40% Hispanic, and 11% other or unknown. Custody at discharge w as to mothers (38%), other family members (25%), or agency foster care (36%). Placement outside the family was greater when mothers had prio r child welfare records, in Blacks vs others, with no prenatal care, a nd when mothers were younger at their first delivery or older at the i ndex birth. Denial of custody to the mother was higher with prior chil d welfare involvement, in Blacks, and when the mother did not live in her own home. Both models also controlled for parity, child sex, and b irthweight. Conclusions. Earlier involvement with child welfare author ities, race, and other factors predict continued separation of mothers and children at newborn discharge, suggesting the need to reexamine c urrent polices and practices.