1. Substance Abuse in Pregnancy: Recognizing the Problem; Seeking Solutions

2. Infant Mortality Albemarle, Charlottesville and Virginia Five-Year Rolling Averages, 1998-2008

3. Infant Mortality by Race Albemarle, Charlottesville and Virginia, Five-Year Rolling Averages, 1998-2008

4. Percent of Low Weight (<2500g) Births Albemarle, Charlottesville, Virginia Two-Year Rolling Averages,1998-2008 Source: Virginia Department of Health

5. Percent of Live Births in which Maternal Substance Abuse Was Reported Charlottesville, Albemarle, and Virginia Four-Year Rolling Averages 2000-2008

6. Percent of Live Births in which Tobacco Use Was Reported Charlottesville, Albemarle, and Virginia Four-Year Rolling Averages 2000-2008

7. Substances Reported Charlottesville and Virginia, 2008

8. Birth Certificate Data Source: Virginia Department of Health, Division of Health Statistics and Division of Vital Statistics Hospitals required to collect information from the mother –MJH Questions Asks how much alcohol do you drink each day? How much tobacco do you use to each day? Number of years? What recreational drugs do you use/frequency? Under-reported

9. IPO Focus Groups - 2009 Mentor mothers (4) with Resource Mothers, FOCUS Females (26) from Charlottesville neighborhoods with higher proportion of low birth weight or premature births –Ages 15 – 73 years (median 26.5 years) –Majority African-American –Westhaven, Blue Ridge Commons, Attention Home –19 females were, or had ever been, pregnant –39% reported that they themselves or someone they knew had given birth to a baby that died before one year of age

10. Findings: Substance Use Substances, especially cigarettes and marijuana, are regularly used before and during pregnancy to cope with stress Consequences for the fetus are not fully appreciated

11. National Institute on Drug Abuse (NIDA) Of women who use illicit drugs, about half are of childbearing age (15 to 44 years old) Nationwide hospital survey to determine the extent of drug abuse among pregnant women in the United States – 1992-93

12. Of 4 million women who gave birth –19% (757,000) drank alcohol –21% (820,000) smoked cigarettes –6% (221,000) used illegal drugs 119,000 - marijuana 45,000 - cocaine

13. Generally, rates were higher in women: –who were not married –had less than 16 years of formal education –were not working –relied on some public source of funding to pay for their hospital stay

14. Estimated Number by Race Alcohol –White - 588,000 –African American - 105,000 –Hispanic - 54,000 Tobacco –White - 632,000 –African American -132,000 –Hispanic - 36,000

15. Age Differences Rates of marijuana use were highest among those under 25 years old Rates of cocaine use were higher among those 25 years and older