While there is a general shortage of treatment centers for drug users, facilities that cater for women’s needs are even scarcer. Many in-patient treatment centers do not accept pregnant women and may drop women from treatment if they become pregnant. The reasons for this can range from a lack of sex-segregated accommodation to a lack of facilities to deal with pregnancy. Most treatment programs are unable to provide the prenatal medical services or the extensive support these women need. On the other end, prenatal care programs often do not have the resources to cope with the personal, social, medical, and other problems of drug-dependent pregnant women.

In general, pregnant drug using women do all that they can to take responsibility of their situation, making efforts, for example, to stop or reduce their drug use and to improve their own health for the sake of the pregnancy. Nevertheless, along with the shortage of adequate treatment programs, pregnant women seeking therapy face many other barriers to care and recovery. Treatment settings in which both clients and staff tend to be men often overlook areas of particular importance to women – such as issues of physical and sexual abuse, learning effective parenting, learning how to deal with a pregnancy and the effects drug use may have on the unborn child, and developing skills that will allow them to provide for themselves and their children. If women seek help beyond drug treatment centers they may find that abortion services are unavailable or unfunded, or that they cannot access prenatal care services without risking loss of custody of their children.

In part, this deficit of adequate treatment can be linked to the social stigma women drug users face because they fail to fulfill our society’s standard of female values and traditional family roles. Today’s discrimination of drug using pregnant women also stems from the ‘crack baby’ scare of the 1980s  during which misleading and often inaccurate stories highlighted damaging effects of prenatal exposure to cocaine. Since then, women have been prosecuted in a number of states for either child abuse or delivering drugs to a minor because they used illicit drugs during pregnancy. Such discrimination is particularly apparent in the experiences of black women who, regardless of similar and equal levels of illicit drug use during pregnancy, are 10 times more likely than white women to be reported to child welfare agencies for prenatal drug use.

While the number of women incarcerated for drug offences has increased four-fold over the past two decades, there remains a lack of research into women drug offenders – the majority of which are drug users – and the requirements of female oriented health projects. Rather than ignoring the fact that there are pregnant drug users or branding these women as criminals, America needs to establish a public health approach designed for women. This should include the acknowledgment of differences between men and women when it comes to types of drugs utilized, levels of addiction, social backgrounds, and physical experiences such as pregnancy.