Perinatal Substance Use Patterns in Obstetrics-Gynecology

Abstract

Alcohol, tobacco, and other drug abuse (ATODA) prevalence and use patterns were examined in a university-based ambulatory clinic. Anonymous and confidential questionnaires, interviews, and medical record reviews were conducted with a sample of 139 women. Participants tended to be young (average age was 23 years old), unemployed (93%), and never married (55%). The average participant was 20 weeks pregnant and had sought care at 14.9 weeks. Thirty-eight percent were smokers, with 21.3 and 8.8% reporting use of alcohol or other drugs during pregnancy, respectively. Less than a quarter recalled being asked by their physicians or the clinic staff about alcohol and other drug use. Slightly more recalled being asked about tobacco (25.7%) and nutritional habits (31.6%). Assessment of ATODA issues is difficult with this population, where fear of prosecution may augment the standard barriers of denial and stigmatization. Nevertheless, it is clear that perinatal substance abuse requires more effective education and training in brief assessment and intervention strategies for ambulatory clinic staff as well as community treatment linkages.