{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:08:11Z","timestamp":1784290091787,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K23DA048169"],"award-info":[{"award-number":["K23DA048169"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Although state, federal, and professional guidelines stipulate the need for informed consent for toxicology testing during pregnancy, consent is often inadequately obtained. The objective of this study was to explore birthing person and obstetric clinician experiences with consent for toxicology testing during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi\u2010structured qualitative interviews were conducted with 25 obstetric clinicians and 15 birthing persons who had toxicology testing performed during their delivery hospitalization. Interviews assessed clinical decision\u2010making around toxicology testing, perceptions of testing utility, as well as consent and communication practices. Transcripts were then double\u2010coded and analyzed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three primary themes were identified. First, information disclosure during consent conversations for toxicology testing deviated from normative standards for informed consent in obstetrics. Second, barriers to adequate information provision included clinicians\u2019 limited knowledge of and discomfort with the test's risks, the infrequency of testing in clinical practice, and birthing peoples\u2019 discomfort asking questions within the physician\u2013patient power hierarchy. Third, birthing people felt unable to decline testing due to fears of child protective services involvement and perceived pressure from clinicians to undergo testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While both birthing people and clinicians identified challenges related to appropriate information provision during consent conversations, birthing people critically underscored a lack of voluntariness related to their fears of child protective services and experiences of pressure from clinicians to consent to testing. As a result, consent practices failed to adhere to normative standards for informed consent within obstetrics, which undermined patient autonomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70295","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:08:27Z","timestamp":1777381707000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cInstead of just a drive by\u201d: Clinician and birthing person perspectives on consent for toxicology testing during pregnancy"],"prefix":"10.1002","volume":"2","author":[{"given":"Leah N.","family":"Schwartz","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Mass General Brigham Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellis J.","family":"Yeo","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Columbia Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly R.","family":"Siegel","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Biology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mishka","family":"Terplan","sequence":"additional","affiliation":[{"name":"Friends Research Institute  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Holland","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Boston Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6435-1016","authenticated-orcid":false,"given":"Davida M.","family":"Schiff","sequence":"additional","affiliation":[{"name":"Division of General Academic Pediatrics, Division of Newborn Medicine Mass General Brigham for Children  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah N.","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Biology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.03.022"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002235"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001781"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004808"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100453"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.2058"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.0908"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2023.01.012"},{"key":"e_1_2_9_10_1","unstructured":"American Society of Addiction Medicine.2022.Substance Use and Substance Use Disorder among Pregnant and Postpartum People.https:\/\/www.asam.org\/advocacy\/public\u2010policy\u2010statements\/details\/public\u2010policy\u2010statements\/2022\/10\/12\/substance\u2010use\u2010and\u2010substance\u2010use\u2010disorder\u2010among\u2010pregnant\u2010and\u2010postpartum\u2010people."},{"key":"e_1_2_9_11_1","unstructured":"Substance Abuse and Mental Health Services Administration.Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants. 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