Pregnant Women's Acceptability of Alcohol, Tobacco, and Drug Use Screening and Willingness to Disclose Use in Prenatal Care



      Despite the prevalence of alcohol, tobacco, and other drug (ATOD) use screening as part of prenatal care, pregnant women's perspectives on screening are largely absent from research and clinical practice. This study examines pregnant women's acceptability of ATOD screening and willingness to disclose their ATOD use in prenatal care.


      Pregnant women completed a self-administered survey and structured interview at four prenatal care facilities in Louisiana and Maryland (N = 589). Participants reported the acceptability of screening and their willingness to honestly disclose their ATOD use to their provider. Data were analyzed through descriptive statistics, tests of proportions, simple regression models, and coding of open-ended responses.


      Nearly all pregnant women found screening acceptable for alcohol (97%), tobacco (98%), and other drug use (97%) during prenatal care. The acceptability of alcohol use screening was higher among those who reported binge drinking (98% vs. 96%; p = .002) and risky alcohol consumption (99% vs. 96%; p = .018). The acceptability of screening for other drugs was higher among women reporting binge drinking (98% vs. 96%; p = .032) and other drug use (98% vs. 96%; p = .058). Almost all pregnant women indicated that they were willing to disclose their alcohol (99%), tobacco (99%), and other drug use (98%) to their provider.


      Almost all women considered verbal screening for ATOD use during prenatal care acceptable and indicated that they were willing to honestly disclose their ATOD use. Verbal screening may allow for the opportunity to initiate safe, nonjudgmental conversations about women's substance use, risk, and goals for their ATOD use, pregnancy, and parenting.
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      Signy M. Toquinto, CNM, WHNP, MS, MA, is Certified Nurse Midwife and Women's Health Nurse Practitioner at MarinHealth Medical Center & Marin Community Clinic, in Kentfield and San Rafael, California.


      Nancy F. Berglas, DrPH, is a public health social scientist at Advancing New Standards in Reproductive Health in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco.


      Monica McLemore, PhD, MPH, RN, is an Associate Professor in the Family Health Care Nursing Department and an affiliated scientist at Advancing New Standards in Reproductive Health, both at the University of California, San Francisco.


      Ana Delgado, CNM, MS, is an Associate Clinical Professor at Zuckerberg San Francisco General Hospital and the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco.


      Sarah C.M. Roberts, DrPH, is an Associate Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences and a public health social scientist at Advancing New Standards in Reproductive Health, both at the University of California, San Francisco.