Numerous studies have documented the deleterious physical, psychological and developmental effects of drug use during pregnancy on fetal and maternal health. Violence during pregnancy has been associated with preterm labor, miscarriages, still-births and low birth weight. The possibility of continued violence against a woman after delivery and the potential extension of this violence to the child make the victimization of pregnant drug users a social problem with enormous public health implications. Previous studies have established links between women's victimization and substance abuse, but there is very little information available about the factors associated with violence during drug-involved pregnancies. Therefore, we propose to conduct an exploratory depth interview study of pregnant drug users (PDUs) who have experienced one or more victimizations (physical, sexual and/or emotional) while pregnant. We will begin by using ethnographic field work methods to locate and recruit 300 women who are currently or were recently pregnant and have used marijuana, crack/cocaine, heroin/opiates and/or methamphetamine singly or in combination (including alcohol with one or more of the above). We will then collect information concerning demographics, family, drug use, relationship and reproductive histories employing a structured questionnaire. This instrument will also be designed to measure levels of drug use and incidence of victimization during their current or most recent pregnancy. We estimate approximately 100 of these interviewees will qualify for and agree to participate in the second session, a qualitative depth interview focussing on their drug use and victimization histories with an emphasis on victimizations experienced during pregnancy. The products of this proposed study will include: l) an exploration of the time order of women's drug use and victimizations 2) a deeper understanding of the social context of drug-involved pregnancy and victimization from the women's perspective 3) victimization measures that have been modified for use with this study population; 3) pilot work for a large scale study that can test emergent hypotheses with a control group.
