Perspectives of pregnant substance-using women: findings from the California Perinatal Needs Assessment.

This article reports on selected major findings of a study on alcohol and drug use patterns and problems and unmet service needs, drawing on interview data from a sample of substance-involved pregnant women who were clients at public health, social service, and criminal justice agencies in two California counties. Based on screening rates, a sizable group of pregnant agency clients regularly used alcohol and other drugs, particularly marijuana and cocaine, and most of these users had not been in substance abuse treatment. Reported use of alcohol and other drugs diminished considerably during pregnancy. Negative consequences of alcohol and drug use, problems with family and friends' substance use, neighborhood alcohol and drug problems, and substance-related violence were widely experienced. The greatest service needs include job placement, educational programs and housing. Prenatal health care was widely received, although often inconsistently or late in the pregnancy. Despite high treatment satisfaction among those in recovery programs, relatively few women desired formal treatment. These findings, which are consistent with those of other recent studies, suggest the complexity of problems and needs among substance-involved, low-income pregnant and parenting women.