What’s Best for Newborns and Parents When Substance Use Is Involved? With Dr. Sharon Ostfeld-Johns

When substance use is involved during pregnancy, the instinct to protect a baby can quickly lead to testing, reporting, child welfare involvement, and possible separation. But what if pregnancy is also one of the most important opportunities we have to help a parent recover, stabilize, and safely care for their child?

In this episode of Community In-Site, host Valerie Frost speaks with Dr. Sharon Ostfeld-Johns, who is dual board certified in internal medicine and pediatrics and is an Assistant Professor of Clinical Pediatrics and Internal Medicine at Yale University School of Medicine. Dr. Ostfeld-Johns appears in this episode in her personal capacity and not as a representative of any organization.

Dr. Ostfeld-Johns has worked to rethink how hospitals respond when babies are born substance exposed, including reducing unnecessary newborn toxicology testing and developing more compassionate Family Care Plans. Her work raises a central question: can systems respond seriously to risk without automatically treating substance exposure as evidence that a parent and baby should be separated?

Together, Valerie and Dr. Ostfeld-Johns explore why pregnancy can be such an important window for treatment and support, how stigma and fear can push parents away from care, what compassionate Family Care Plans look like in practice, and how CAPTA notifications, child welfare reports, and hospital decision-making can become conflated.

The conversation asks whether infant safety and family preservation have to be competing goals, or whether a more coordinated and evidence-informed response can give babies and parents a better chance to remain together safely.