Objectives. Prenatal patients were studied to examine the proportion o
f women who had been violence victims, women's patterns of Substance u
se (cigarettes, alcohol, and illegal drugs) before and during pregnanc
y, and relationships between violence and substance use. Methods. More
than 2000 prenatal patients in North Carolina were screened for viole
nce and substance use. Relationships between violence and patterns of
substance use before and during pregnancy were examined, as well as wo
men's continuation of substance use during pregnancy as a function of
violence and Sociodemographic factors. Results. Twenty-six percent of
the women had been violence victims during their lives. Before pregnan
cy, 62% Of the women had used one or more substances; during pregnancy
, 31% had used one or more substances. Both before and during pregnanc
y, violence victims were significantly more likely to use multiple Sub
stances than nonvictims. Continuation of substance use during pregnanc
y was significantly more likely among violence victims than nonvictims
. Conclusions. Care providers should screen women for violence as well
as for substance use and should ensure that women are provided with a
ppropriate interventions.