INTRODUCTION: Women of color and low socioeconomic status (SES) are more often reported to child protective services (CPS) upon testing positive for drug use in pregnancy. We set out to examine CPS reporting and referral patterns by race and SES among hospital social workers (SW) for pregnant women testing positive for isolated marijuana use. METHODS: Retrospective chart review study of pregnant women seeking obstetrical care at a Midwestern academic hospital in 2017. Patients were included if their lab work indicated one or more positive tetrahydrocannabinol (THC) drug screening results, with no other illicit drug use reported or screened positive throughout pregnancy. Lab reports, provider referrals to SW, SW notes, and reporting to CPS were collected. This study was approved by the IRB. RESULTS: Seventy-seven patients met eligibility criteria. 63.6% were white and 77.8% were publicly insured. The average age was 25 years (18–37). However, documentation and reporting by providers and SW's were inconsistent, raising concerns regarding the quality and reliability reporting procedures. We noted the following inconsistencies: 1) Provider notification of SW varied, 2) inconsistent reporting by SW to DCS, 3) lack of standardized documentation in medical record. CONCLUSION: We identified numerous barriers to collecting the data needed to assess the relationship between race, SES, and CPS reporting. Uniform and universally applied reporting procedures are needed for future assessment, measurement and quality control in this arena. Given the widespread movement toward decriminalization, it will be important to document and study the impact of marijuana use in pregnancy on services and penalties rendered.