Support, Not Sanctions, May Help Pregnant Women at Risk for Substance Abuse

Between 1992 and 1995, the March of Dimes Birth Defects Foundation, East Central Florida Chapter in Orlando, Fla. and the Farmworker Association of Florida in Apopka, Fla., developed self-help and empowerment groups for pregnant and postpartum women with the aim of reducing substance abuse and improving pregnancy outcomes in high-risk communities.

Maternal substance abuse affects 10 percent of all newborns in Florida. Intervention efforts have come primarily through child protection services, whose punitive focus discourages many women from seeking help.

The Resources Sisters/Compañeras project serves women in Orange and adjoining counties. Working in groups, women learn the dangers of substance use during pregnancy, discuss relationship difficulties and address a range of other issues of concern to them.

Key Results

  • Nearly 3,000 women were served by peer counselors in their home communities. Project staff trained 14 peer counselors who served women through group meetings, home visits and telephone contacts.

  • Participants valued the support groups. Support groups made an important contribution in the lives of many of the women, according to interviews and an analysis of focus group sessions.

  • Peer counselors appeared to grow in skill and self-efficacy. The peer counselors described an increased sense of empowerment and enhanced options since joining the program. Some said it provided a bridge from low-skilled, dead-end employment to further education and career possibilities.

  • No impact on birthweight was demonstrated. An evaluation by the University of South Florida-Tampa compared births to women who participated in the project's first year (1993) with births to nonparticipants in the same zip codes.

    When women with similar sociodemographic risk factors were compared, there was no statistically significant difference between the rate of low-birthweight infants in the participant and nonparticipant groups. Some women reported reducing or eliminating use of tobacco during pregnancy.