Through interviews with 120 pregnant, or recently delivered, drug-using women, this book examines how pregnant drug addicts make choices about drug use, pregnancy and pre-natal care. To combat the stereotype of the negligent, uncaring and even abusive pregnant drug user, the authors seek to understand the feelings and motivations of the women themselves. How do they decide whether or not to terminate their pregnancy? What are their parents' and family members' attitudes toward their pregnancy? What options are available to them if they choose to keep the baby but kick the habit? The authors present the demographics of their study population and a description of their lives: their childhoods, drug use patterns, relationships and experiences of violence. They delineate women's efforts to manage their pregnancies and reduce the potential harms of drug use during pregnancy. They detail what they call the ""final showdown"" of birth and delivery when months of ambivalence, fear and harm reduction efforts culminate in the glaring light of an institutional setting. Finally, they address the policy implications of their findings.