CALIFORNIA APPROACH TO PERINATAL SUBSTANCE-ABUSE - TOWARD A MODEL OF COMPREHENSIVE CARE

In the late 1980s and early 1990s there was a growing awareness of the many health, social, psychological, treatment, and recovery needs of pregnant and parenting women and their drug-exposed children. This awa reness sensitized policymakers and service providers to the necessity for women-centered programs. Many points of intervention, from primary prevention to treatment of drug dependence, are required to adequatel y respond to the various needs of this heterogeneous population; a com prehensive women-centered model of care is required that includes heal th, social, and personal support services. In addition, programs are n eeded that are aimed at the prevention and treatment of use, abuse, an d addiction to alcohol and tobacco, which are dangerous to women's hea lth and birth outcomes and responsible for more costs to society than are associated with use of illicit drugs. The existing system of socia l services and health care has been fragmented and uncoordinated in re sponding to substance-abusing women generally, and especially to those who are pregnant and/or parenting. A panel of experts and policymaker s in California delineated the appropriate components of a model of se rvice delivery for pregnant and parenting women. This article assesses the implementation of California programs that were informed by the m odel.