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Improving pregnancy outcomes among high-risk mothers who abuse alcohol and drugs: Factors associated with subsequent exposed births

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  • Grant, Therese
  • Christopher Graham, J.
  • Ernst, Cara C.
  • Michelle Peavy, K.
  • Brown, Natalie Novick

Abstract

Parental alcohol and drug abuse is a factor in approximately 15% of the cases investigated by the child welfare system and in approximately one quarter of cases with substantiated maltreatment. While substance abuse treatment is generally an essential component of child welfare family plans, a relatively low proportion of substance abusing mothers involved in the child welfare system complete treatment, which typically results in placement of their children in substitute care and the beginning of a new generation of adaptive problems. This longitudinal study explores whether loss of an index child due to substance abuse is associated with risk of a subsequent alcohol/drug-exposed birth in a sample of 795 substance-abusing mothers enrolled in the Washington State Parent–Child Assistance Program (PCAP). Results indicate that at program exit, over one-fifth of these women had a subsequent birth (SB) after the birth of their index child. Among these women, over half (i.e., 56.3% or 12.3% of the entire sample) used alcohol and/or drugs during the subsequent pregnancy. Consistent with our main hypothesis, the adjusted odds of having a SB were increased nearly two-fold for women who had the index child removed from their care. Furthermore, among mothers with subsequent births, the adjusted odds of having an exposed SB were increased three-fold if the index child had been removed from the mother's care. We discuss implications of our findings for child welfare policy and practices.

Suggested Citation

  • Grant, Therese & Christopher Graham, J. & Ernst, Cara C. & Michelle Peavy, K. & Brown, Natalie Novick, 2014. "Improving pregnancy outcomes among high-risk mothers who abuse alcohol and drugs: Factors associated with subsequent exposed births," Children and Youth Services Review, Elsevier, vol. 46(C), pages 11-18.
    • Handle: RePEc:eee:cysrev:v:46:y:2014:i:c:p:11-18
    DOI: 10.1016/j.childyouth.2014.07.014
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    References listed on IDEAS

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    1. Choi, Sam & Ryan, Joseph P., 2007. "Co-occurring problems for substance abusing mothers in child welfare: Matching services to improve family reunification," Children and Youth Services Review, Elsevier, vol. 29(11), pages 1395-1410, November.
    2. Huang, Hui & Ryan, Joseph P., 2011. "Trying to come home: Substance exposed infants, mothers, and family reunification," Children and Youth Services Review, Elsevier, vol. 33(2), pages 322-329, February.
    3. Grant, Therese & Huggins, Janet & Graham, J. Christopher & Ernst, Cara & Whitney, Nancy & Wilson, Dee, 2011. "Maternal substance abuse and disrupted parenting: Distinguishing mothers who keep their children from those who do not," Children and Youth Services Review, Elsevier, vol. 33(11), pages 2176-2185.
    4. Marsh, Jeanne C. & Ryan, Joseph P. & Choi, Sam & Testa, Mark F., 2006. "Integrated services for families with multiple problems: Obstacles to family reunification," Children and Youth Services Review, Elsevier, vol. 28(9), pages 1074-1087, September.
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    Cited by:

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    2. Bedston, Stuart & Philip, Georgia & Youansamouth, Lindsay & Clifton, John & Broadhurst, Karen & Brandon, Marian & Hu, Yang, 2019. "Linked lives: Gender, family relations and recurrent care proceedings in England," Children and Youth Services Review, Elsevier, vol. 105(C), pages 1-1.
    3. Vivian Lyall & Lindsay Wolfson & Natasha Reid & Nancy Poole & Karen M. Moritz & Sonya Egert & Annette J. Browne & Deborah A. Askew, 2021. "“The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy," IJERPH, MDPI, vol. 18(7), pages 1-24, March.
    4. Lloyd, Margaret H. & Akin, Becci A. & Brook, Jody, 2017. "Parental drug use and permanency for young children in foster care: A competing risks analysis of reunification, guardianship, and adoption," Children and Youth Services Review, Elsevier, vol. 77(C), pages 177-187.
    5. Mike Shaw, 2021. "A Proof-of-Concept Pilot for an Intervention with Pregnant Mothers Who Have Had Children Removed by the State: The ‘Early Family Drug and Alcohol Court Model’," Societies, MDPI, vol. 11(1), pages 1-12, January.
    6. Carol Hubberstey & Deborah Rutman & Rose A. Schmidt & Marilyn Van Bibber & Nancy Poole, 2019. "Multi-Service Programs for Pregnant and Parenting Women with Substance Use Concerns: Women’s Perspectives on Why They Seek Help and Their Significant Changes," IJERPH, MDPI, vol. 16(18), pages 1-18, September.

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