The use of both illicit and licit drugs by pregnant women is key public health concern which has garnered considerable governmental, mass media, and medical attention given the increased health risks substance abuse poses for pregnant women as well as fetuses. This paper argues that the growing prevalence of substance abuse among pregnant women is rooted into poor social conditions, which place them at high risk for getting involved into drug use.

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The first series of studies into the risk factors for perinatal substance exposure appeared in the 1990s. In particular, the 1992 National Pregnancy and Health Survey identified a range of social factors that posed considerable risks for pregnant women’s substance abuse. Those included unmarried status, being unemployed, having less than 16 years of formal education, and getting inadequate healthcare (relying on public assistance to pay for healthcare services). For alcohol users, those factors did not work out, since the rate of alcohol addiction were higher amongst employed women, with college education, as well as private insurance (Huang & Reid, 2006).

Analysis of the baseline data from the Fragile Family and Child Well-Being Survey by Huang & Reid (2006) confirmed earlier findings and yielded new results. The research focused on the stratified random sample of 200,000 mothers living in 77 largest U.S. cities. First of all, Huang & Reid (2009) found that the prevalence of illicit drug use among the study participants was 6%, with around 3% of pregnant women using both substance and alcohol. Moreover, higher rates of illicit drug abuse were found in African-American and Hispanic pregnant women, whereas higher rates for cigarette and alcohol abuse were found in Caucasian pregnant women. Social factors that increased the probability of illicit substance abuse among pregnant women were receiving welfare benefits within the last year, being unmarried, having low educational attainment (less than high school), being a school dropout, having income lower than 50% of the officially established poverty line, not living with a child’s father, having a non-immigrant status, not attending religious services, and having disagreements about pregnancy. For instance, women who got welfare benefits for the preceding year were 42% more likely to get addicted to illicit drugs and 53% more likely to get addicted to tobacco use (Huang & Reid, 2006).

Scholars agree that socio-economic factors pose the greatest risks for substance abuse and addiction among pregnant women. Women living in inadequate socio-economic conditions are frequently overwhelmed by various stressors in their everyday lives, which makes them depressed and anxious, lowers their self-esteem, and leads them to drug addiction. Moreover, although most manage to abstain from substance use, a certain proportion of women (5-14 depending on a survey) fail to give up drugs once they find out about their pregnancies (Smith, 2012). As these women continue using illicit and licit drugs during their pregnancies, they hardly seek adequate perinatal as well as prenatal care. Therefore, their unborn children face the risks of severe biological vulnerabilities (such as emotional, cognitive, and behavioral deficits) and adverse health conditions inherited from their mothers (HIV/AIDS, sexually transmitted diseases, anemia, etc) (Smith, 2012).

In this way, researchers agree that the best way to address the problem of drug addiction among pregnant women in the U.S. is to adopt family-focused as well as ecological approaches. The first, if implemented correctly, will lead to increase in the number of pregnant women living with the children’s fathers and thus will decrease the probability of drug addiction by up to 81%. The second will help resolve the socio-economic problems facing the pregnant women and thus will provide major support to these women’s drug addiction withdrawal efforts. Moreover, by meeting the broad social and economic needs of women from the most vulnerable categories the government will prevent their drug addiction. This will mean that the children will be conceived and born by healthier mothers.

  • Huang, C.-C. & Reid, R. (2006).Risk factors associated with alcohol, cigarette, and illicit drug use among pregnant women. Journal of Social Service Research, 32 (4), 173-185.
  • Smith, C. (2012). Indirect screening: Enhancing identification of illict drug use during pregnancy. PhD Thesis. Virginia Commonwealth University.