We aimed to determine if the trend in substance use in this central co
re of a large inner-city area confirmed an increase in marijuana use a
mong young women <22 years of age as childbearing years were beginning
or if marijuana use and harder drug use were greatest among women bey
ond the teens and the early second decade of life and to describe one
prenatal care intervention. Statistical reports for the Special Prenat
al Clinic, a Harlem clinic for women with a current or past history of
substance use, were reviewed from 1985 (the clinic's inception) throu
gh March 1996 to determine the trends, patterns, and types of drug use
. Findings chronicled the beginning and rise in crack cocaine use, esp
ecially after 1986, confirmed an increase in marijuana use by adolesce
nts since 1992, and suggest that the risk for use of hard drugs increa
ses with age, predominantly in the childbearing years. Intervention by
the Special Prenatal Clinic aided casefinding, allowed for comprehens
ive care, offered women opportunities for behavior change, and increas
ed their chances of keeping their babies after delivery.