The specific aims of this study are to describe the prenatal and other health care utilization of drug-abusing pregnant women, and to examine the factors that are related Health Belief Model. The long-term goal of the study is to determine what factors are related to utilization of prenatal care and drug treatment services in drug-using women, and thus to provide information that will be useful in bringing drug-using women into care. Prenatal care is highlighted because it offers and opportunity to motivate drug users to stop or reduce their drug consumption; and it provides access to other important health and social services for these women and their infants. A very important aspect of prenatal care for drug-using women is that may provide the opportunity to educate drug-users about the dangers of AIDS and how they can reduce the risk to themselves and their unborn infants. A non-concurrent prospective design will be used to conduct a survey of approximately 1113 public patients who deliver at Johns Hopkins Hospital during a 12-month period. This number is estimated to include 357 drug users, 170 women who received no prenatal care, and 587 non-drug users who received prenatal care. Drug use will be determined by a positive result on any four measures: a universal toxicology screen of all mothers; self- report Of drug use at interview; indications in the medical or prenatal records of the mothers and their infants; or toxicology results on newborns. Data will be collected from abstractions of medical and prenatal care records, and by interview. Interview of the mothers will include data on prenatal care during this pregnancy, previous use of health care, attitudes toward health and health care, extend and nature of social support, use of drugs, smoking, drinking, and other variables such as depression, locus of control, domestic abuse, and transiency. The questionnaire includes a number of standardized measurement instruments with good psychometric properties. A pilot test of the questionnaire with 20 women indicates that women on the post-partum unit of the hospital will provide such information.
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