Substance use during pregnancy among women offenders

Three-quarters of women newly admitted to a Correctional Service of Canada (CSC) institution reported a previous pregnancy. Of these, about one-in-five indicated using alcohol and drugs during at least one pregnancy, which is of concern given the adverse effects of this use on children's health. These findings are especially worrisome when combined with other known social determinants associated with birth outcomes, such as poverty, homelessness, and a history of domestic violence, which are also relatively common among women offenders. These findings suggest that women offenders may benefit from education about healthy choices during future pregnancies.

Of the 709 women examined, 18% stated that they used alcohol and 22% said they used drugs during their pregnancy. About half of those who reported drinking said they binged - that is, consumed three or more drinks per session. Among those who used drugs, the most frequently reported were cocaine/ crack (48%), marijuana (41%), and opioids (24%). Most women only drank or used once or a few times during the pregnancy, but a quarter of women who drank and almost half of those who used drugs did so at least once a month.

Many of the women acknowledged the effects their substance use had on their children. Over 40% of those who drank and about a third of those who used drugs believed their use affected their child's health. One-in-five (21%) women who indicated pre-natal alcohol use reported having a child who had been diagnosed with Fetal Alcohol Spectrum Disorder. In other words, the rate for this study (including women who had never drank) would be almost 4%, which is considerably higher than the rate of about 1% in the general Canadian population^{Footnote 1}. Moreover, women who used drugs during pregnancy reported that their child had difficulty keeping up in school twice as often as those who did not use drugs (20% as compared to 10%).

Factors associated with substance use during pregnancy included being Aboriginal, having a previous criminal offence, or substance use linked to the current offence. Prenatal substance use was also associated with substantial or severe substance use problems, problematic use of both alcohol and drugs, or a history of injection drug use.

Substance use during pregnancy is known to pose significant risks to the child in terms of birth weight, cognitive development, and other adverse health consequences. Despite the fact that many women offenders are mothers, little is known about substance use during pregnancy in this population.

Results from the Women's Computerized Assessment of Substance Abuse (WCASA), which assesses women's substance use issues at admission to federal custody, together with other administrative data, were examined for women who reported having been pregnant. In total, 709 (74%) of the 962 women who completed the instrument from February 2010 to February 2014 reported ever having been pregnant and were included in the data analysis.

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Prepared by: Renée Gobeil, Shanna Farrell MacDonald, and Mary B. Ritchie