This proposed exploratory study is the first step in a larger research agenda to investigate the impact of two distinct types of state laws regarding alcohol use during pregnancy (public health-oriented or punitive) on pregnant women's decisions to seek substance abuse treatment and prenatal health services. The relevance of this study is that FASD is a critical health issue about which policy choices are being made without evidence based research about the impact of those choices on healthy fetuses, healthy children, substance abuse-free women, and intact, stable families. The study's specific aims include: 1) To set the stage for the first study to assess implementation impact across types of alcohol and pregnancy policy. In this pilot, we will test the adequacy of research design, data collection instruments (especially those designed for use with women to whom the policies are targeted), and the feasibility of rigorous, systematic data collection in one state, California, with a mixed set of alcohol and pregnancy policies. 2) To provide evidence-based guidance of the effects of public health and punitive laws to policymakers who seek to improve birth outcomes in their states. 3) To employ an interdisciplinary research design that relies on multiple methodologies, stages, and standpoints to reflect each element of the policymaking, policy implementation, and service delivery systems. The stages of the proposed eighteen month study are as follows: 1) Update and expand the statutory, regulatory and case law in California. 2) Collect and analyze publicly-available national and county-level data and evaluate their adequacy to assess the need for services, the extent of service provision, and the manner in which the services have been provided. 3) Identify and interview key personnel in California state and county agencies and legislative committees who make policy for and interact with pregnant women substance abusers. 4) Using the key contacts in each of three selected counties, conduct interviews and focus groups with a broad range of affected women. ? ? ?
