Promotion of Maternal and Child Health: A Path Model of Care for Substance Using Pregnant Women

Maternal use of licit and illicit substances during pregnancy has been shown to have serious effects on the fetus, the pregnancy outcome, and the physical, emotional, and social growth of children after birth. Such children require specialized and intensive care during their growing years. Substance using women themselves face a series of related consequences in physical and mental health, and in social functioning, which in turn limit their parenting abilities, often resulting in neglect and abuse of children. Many substance using pregnant women coming to public attention are economically disadvantaged and Medicaid recipients, requiring costly intensive care during pregnancy and subsequently in the development of children. Four fields of human services, namely, Public Health, Substance Abuse Treatment, Child Welfare, and Criminal Justice, have responded to these problems in recent years. This paper examines the existing treatment models in these fields, and proposes a comprehensive, coordinated, and managed care model for improving the current service delivery.