Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose Adolescents who become pregnant are at risk for a variety of types of problem behavior, including substance use. However, the experience and demands of pregnancy and early parenting might be expected to alter young women's behavior patterns. This study provides descriptive, longitudinal data on alcohol and cigarette use patterns over time in a sample of young, urban mothers.

Methods 208 pregnant African-American women between the ages of 14 and 21 (mean 18.27 years) were interviewed during pregnancy and 12-months postpartum. Data will be presented on their reports of substance use prior to pregnancy and at 12-months postpartum.

Results Substance use trajectories over time were categorized according to whether women used both before pregnancy and after giving birth (user), used only before pregnancy and did not resume after the birth (desister), started using in the first year postpartum (starter), or never used (non-user). For drinking, most women were non-drinkers (n=89); 63 were drinkers at both times, 42 were desisters, and only 13 were starters. There was a trend for starters to be among the older women in the sample. The overall sample showed a 70% decrease in amount of alcohol consumed from before pregnancy to one year postpartum. Although mothers over 18 years old drank more than younger mothers, changes in the amount of alcohol consumed were not associated with women's age. For cigarette use, most women were non-smokers at both times (n=157); 23 were smokers at both times, 21 were starters, and only 7 were desisters. There was a trend for starters to be younger women. The overall sample showed a 50% increase in average numbers of cigarettes smoked from before pregnancy to one year postpartum, with mothers under age of 18 showing large increases.

Implications for Practice Trajectories in use of alcohol and cigarette from the prepregnancy to postpartum periods were different with alcohol use decreasing and cigarette use increasing. With respect to alcohol use, it appears that the transition to parenthood may actually protect mothers from initiation and escalation of drinking. The few women who began drinking during the study were among the older ones in the sample, many of whom achieved legal age during the study. Although data were not collected to address this issue, anecdotal evidence suggests that overall decreases in alcohol use may be linked to changes in mothers' abilities to socialize in group settings with peers following the births of their babies. On the other hand, the first year postpartum may be a time of vulnerability to initiation of smoking, particularly for mothers under age eighteen. This finding has implications for health care and social service systems. Although many obstetric, pediatric, and community-based social service programs target services to pregnant and parenting adolescents, few offer smoking prevention services. These contacts may provide health professionals, including social workers, with opportunities to promote better health habits of young mothers and to protect their children from health risks associated with second-hand smoke exposure.