According to the U.S. Department of Health and Human Services, it may be more difficult for women to seek help for substance use disorder. A woman may be pregnant or breastfeeding and unwilling to tell someone that they are addicted, because they fear losing custody of their child or because of fear of judgement on parental fitness. Women may be more likely to face additional barriers to treatment, such as needing childcare or elder care, to follow through with participation in long term treatment programs or impatient care.