Women described multiple barriers to treatment and healthcare, including a lack of suitable treatment options and difficulty finding and enrolling in treatment. Women’s stories highlighted their strategies for managing their risk of detection by health or criminal justice authorities, including isolating themselves from others, skipping treatment appointments, or avoiding treatment altogether.

The three-part interview schedule included questions about past and current substance use, life history, and experiences with criminal justice authorities, child protective services, and health professionals.

In-depth life history interviews were conducted with 30 recently-pregnant women who had used alcohol or other drugs during their pregnancies. This study explored the experiences of substance-using mothers as they navigated health and criminal justice consequences and accessed needed resources in the community. Negative health consequences associated with substance use impact both the mother and the developing fetus, and there are ongoing attempts to criminalize substance use during pregnancy that put pregnant substance-using women at risk of detection, arrest, and punishment. Substance use during pregnancy and motherhood is both a public health and criminal justice concern.

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