The accessibility of drug treatment for pregnant women: a survey of programs in five cities

Through simulated calls to 294 drug treatment programs in five cities, this study investigated access for pregnant women and compared New York City's provision of services in 1989 to that in 1993. In all sites, the majority of programs accepted pregnant women. There was also a marked improvement in the availability of services in New York City. Yet options were more limited for Medicaid recipients and women needing child care, and an appointment or referral for prenatal care was usually not offered. Although the door for treatment may be opening for pregnant women, institutional barriers still remain.
Substance abuse treatment programs in large cities may accept pregnant women, but payment policies and a lack of prenatal and child care may pose barriers to poor women. A study of 294 drug treatment programs in five cities revealed that most outpatient and residential programs accepted pregnant women. The five cities studied were Albuquerque, NM; Charleston, SC; Detroit, MI; New York, NY, and Portland, OR. Only half of outpatient programs in Albuquerque accepted pregnant women on Medicaid; non-acceptance of pregnant women on Medicaid was a trend in the other four cities as well. Drug treatment programs in New York City were found to be more accepting of pregnant women in 1993 than they were in 1989, but not all of these programs were open to pregnant women on Medicaid. Programs also may not be sensitive to the prenatal care and child care needs of pregnant women.