Here’s something to keep in mind: Many women quit using alcohol and other drugs when they find out they’re pregnant.

Women are most likely to quit using substances if they find out they’re pregnant in their first  trimester. This is often called the “teachable moment.” If service providers say the right things  in the right way to women at this moment, you can really increase the number of women who  will quit using substances. And for those women who don’t quit using substances at the  teachable moment, there are still many ways to engage them both now and later on in their  pregnancies.

This is true even if they are heavy or problem users. So it’s important for you not to feel hopeless or helpless. We hope this website will give you lots of ideas about helping women throughout their pregnancies. Women can be healthier and have healthier babies, even if they’re not able to quit using completely when they are pregnant.

But what about those women who can’t or don’t quit using substances when they find out they’re pregnant? Service providers often have a difficult time understanding why women use substances during pregnancy. This is understandable. You want what’s best for the baby. And it’s best for both baby and mothers if women who are pregnant don’t drink, smoke, or take drugs.

There are lots of reasons why pregnant women might continue to use substances. Here are a few of them.

Reason #1:

Women don’t know they are pregnant. Many women don’t plan to get  pregnant. About half of all pregnancies aren’t planned. So many women don’t know they’re pregnant until the second, or even third, trimester. This is especially true for women who have chaotic lives, who aren’t able to eat nutritious food on a regular basis, or who are using certain drugs. These issues can cause problems with women’s periods and can hide some early signs of pregnancy. It can take longer to figure out they’re pregnant.  So they use substances while they’re pregnant without really meaning to. Then, when they do find out they’re pregnant, they feel guilty and ashamed. And they are too embarrassed to talk about it. So they keep on using.

Reason #2:

Many women are given the wrong information about the effects of alcohol and  other drugs.  This misinformation can come from anywhere—physicians, other service providers, friends, or family.  For example, their family and friends might think it’s OK to drink or take drugs when women are pregnant. They might tell them about other women who drank or used drugs and had healthy babies. It’s important to understand this, because it helps service providers adopt a more non-judgemental attitude. Many pregnant women don’t use substances because they’re irresponsible. The fact is they might not have the right information.

Reason #3:

Most people in their world are also using substances. Many pregnant women  who continue to use substances have partners, family, and friends with alcohol or drug problems. These women don’t get enough emotional or physical support. And they have to cope with the extra stress of living with a problem drinker or drug user. Or if women talk about quitting with their family and friends, they are made to feel like an outsider. It can just feel a lot easier to keep on using.

Reason #4:

Women may be using substances to cope with very difficult situations, such as  poverty, trauma, violence, or depression.
These women continue to use substances because it helps to numb their feelings and experiences. This can be especially true for women in our communities, who have a lot of difficulties to cope with.

Reason #5:

Some women are addicted to substances. The idea of quitting can feel  overwhelming and impossible to achieve. Some women find it more difficult than others. This has nothing to do with willpower. It depends on their situation and how much, how often, and how long they’ve been using substances. Sometimes, pregnant women keep using because it seems easier than trying to quit or cut down. And with some substances (such as opiates), it’s more harmful to the unborn baby for the woman to quit using abruptly.


It’s not just alcohol and other drugs. Many factors can lead to poor birth  outcomes, including poverty, lack of nutritious food, domestic violence, and other difficult life events. Pregnant women who use substances want to be treated within the context of their whole lives, not just as a pregnant woman. Try to be conscious of the difficult situations in which many pregnant women find themselves.

Even if a pregnant woman isn’t able to quit using substances, try to address as many of her other concerns as possible. For example, practical supports (like food programs) mean that she will have good food. This will help her health and the health of her baby even if she isn’t able to quit using substances right away. What helps the mother helps her baby.