BMC Public Health Research article Substance abuse in pregnant women. Experiences from a special child welfare clinic in Norway Bjørg Hjerkinn*1, Morten Lindbæk2 and Elin Olaug Rosvold2 BioMed Central Open Access Address: 1Addiction Unit/Research Unit, Sørlandet Hospital, Kristiansand, Norway and 2Institute of General Practice and Community Medicine, Faculty of Medicine, University of Oslo, Norway Email: Bjørg Hjerkinn* - bjorg.hjerkinn@sshf.no; Morten Lindbæk - morten.lindbak@medisin.uio.no; Elin Olaug Rosvold - e.o.rosvold@medisin.uio.no * Corresponding author Published: 11 November 2007 BMC Public Health 2007, 7:322 doi:10.1186/1471-2458-7-322 This article is available from: http://www.biomedcentral.com/1471-2458/7/322 Received: 30 April 2007 Accepted: 11 November 2007 © 2007 Hjerkinn et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Substance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinic's aims was to support the drug dependent women through their pregnancy without any replacements. The object of this paper is to describe concurrent health and social problems, as well as the predictors for stopping drug abuse, in the clinic's user group. Methods: Retrospective cohort study. Data was gathered from the medical records of all 102 women seen in the clinic in the period between 1992 and 2002. The study includes 59 out of 60 women that were followed until their children were two years old or placed in alternative care, and a comparison group of twice the size. Both groups were presented with a questionnaire concerning both the pregnancy and health and socio-economic issues. Results: Four (4.5 percent) of the women that completed their pregnancies did not manage to reduce their substance abuse. All the others reduced their substance abuse considerably. The odds ratio for stopping substance abuse within the first trimester was significantly associated with stopping smoking (O.R. 9.7) or being victims of rape (O.R. 5.3). Conclusion: A low cost and low threshold initiative organised as a child welfare clinic may support women with substance abuse problems in their efforts to stop or reduce their substance abuse during pregnancy. Background Alcohol and other substances taken by pregnant women can harm the unborn baby [1-3]. Pregnant women who continue their substance abuse often give birth prema- turely, the infants are often small for their gestational age, and they have more perinatal incidents. Despite evidence for a wide range of negative consequences for the preg- nant women and their children, specific programs addressing this group did not begin appearing until the late 1980ies [4]. Female alcoholics and substance abusers have been met with anger and blame, which led to a lack of treatment services. In recent years, models of treatment Page 1 of 8 (page number not for citation purposes)