Supporting Pregnant People Facing Domestic Violence and Substance Use
Pregnancy can be a time of hope – and also a time when stress, relationship conflict, or past trauma can intensify. For some people, that includes intimate partner violence (domestic violence) and substance use. These issues are more common than many realize and can affect anyone, regardless of income, background, or where they live. But there is hope. Help is available, and no one has to navigate these challenges alone.
Understanding the Link Between Domestic Violence, Substance Use, and Pregnancy
Domestic violence often involves power and control – physical harm, sexual violence, threats, stalking, emotional abuse, and financial control. Pregnancy can increase risk because an abusive partner may feel more threatened by changes in attention, finances, or independence. At the same time, people experiencing violence may use alcohol or drugs to cope with fear, anxiety, pain, or isolation. In fact, according to the CDC, “depression, smoking, and using marijuana or other illegal drugs during pregnancy were more than twice as common among those who experienced intimate partner violence during pregnancy compared with those who did not.” This combination can affect:
Physical health: injuries, chronic stress, high blood pressure, complications during pregnancy
Mental health: depression, anxiety, PTSD, and sleep disruption
Pregnancy and newborn outcomes: higher risk of preterm birth and low birth weight, and challenges with bonding and recovery; individuals who experience violence during pregnancy may also be less likely to attend prenatal care visits
Overall safety: violence can escalate, especially around major life changes
None of this is about blame. Both domestic violence and substance use are often linked to trauma, and both are treatable with the right support.
Domestic Violence and Family Safety Indicators in Sacramento
While domestic violence is underreported everywhere, Sacramento County tracks related concerns and substance-use impacts that help show why prevention and support matter, especially during pregnancy. Be Healthy Sacramento, the public health data portal, reports that in 2024, there were 4.8 substantiated child abuse cases per 1,000 children in Sacramento County. Though child abuse and domestic violence are not identical, the two often overlap in households under stress, and pregnancy is a key time to strengthen safety and support. Research shows that in 2022, there were 5,113 calls for assistance with domestic violence in Sacramento County, a rate of 4.2 per 1,000 adults of all genders. These numbers matter because pregnancy can be a period of increased vulnerability, when violence may begin or escalate. National data from the CDC further underscore this risk: approximately 85% of domestic violence survivors are women, and studies have found that nearly half of homicides involving women who were pregnant or within one year postpartum included intimate partner violence. Together, these local and national indicators highlight that domestic violence is not rare; it affects pregnant people at alarming rates, and early screening, safety planning, and connection to Sacramento County support services can be lifesaving.
If You’re Pregnant and Worried About Safety
You deserve to be safe – full stop. Even if you feel unsure that what you’re experiencing is “abuse,” you can still reach out for confidential support. A few safety-focused tips that can help:
Trust your instincts. If something feels off or unsafe, that matters.
Build a small support circle. One trusted person (friend, family member, neighbor, provider) can help you plan.
Use safer ways to reach out. If a partner monitors your phone, consider using a friend’s device or a private browser window.
Create a “quick exit” plan. Keep copies of key documents (ID, insurance card), some cash, medications, and a list of phone numbers in a safe place, if possible.
If you are in immediate danger, call 911.
Helping a Loved One Who Is Pregnant and Facing Violence and Substance Use
If someone you care about is pregnant and you’re worried they may be experiencing domestic violence, substance use, or both, your support can be powerful. At the same time, it’s normal to feel unsure about what to say or do. The most important thing to remember is this: you don’t need to fix everything – you just need to show up with care and without judgment.
What helps most
Listen and believe them. If they share concerns about safety or substance use, take it seriously. Avoid minimizing, questioning, or blaming.
Use nonjudgmental language. Focus on care, not consequences. Try phrases like, “I’m worried about you,” or “You deserve support and safety.”
Respect their choices. Leaving an abusive relationship or changing substance use is complex, especially during pregnancy. Pressure or ultimatums can increase risk.
Offer practical help. This could include childcare, rides to appointments, help making phone calls, or sitting with them while they reach out to a resource.
Share information, not demands. Provide local Sacramento County resources and hotlines, and let them decide when, if at all, to use them.
Know when to reach out for help
If you’re concerned about their immediate safety, call 911. You can also contact local domestic violence hotlines in Sacramento County for guidance – even if the person you’re supporting isn’t ready to call themselves. Advocates can help you think through safe, supportive next steps. Being a steady, compassionate presence can make a lasting difference. Your support can help someone feel less alone.
Sacramento County resources for help and support
Domestic violence and safety support
National Domestic Violence Hotline – 24/7 confidential call, text, chat
Sacramento County domestic violence resource PDF – complete list that includes crisis hotlines and shelters; how to report abuse; children’s emergency services; victim assistance, and how to get a legal restraining order.
WEAVE – Crisis intervention and services for survivors in Sacramento County
Sacramento Regional Family Justice Center – Free, walk-in, comprehensive support: safety planning, legal help, counseling, and more
Sacramento County Domestic Violence and Anger Support – list of classes, resources, and services for families and individuals
Pregnancy, parenting, mental health, and substance use supports
Sacramento County Substance Use Prevention and Treatment Services (SUPT) – Drug and alcohol prevention and treatment care continuum, including outpatient/residential treatment, medication-assisted treatment, withdrawal management (detoxification), perinatal services, and sober living environments/recovery residences.
SACCounty Healthy Beginnings – Resources and local program connections for pregnant people, families, and professionals impacted by substance use during pregnanc
Sacramento County Behavioral Health – offering comprehensive mental health and substance use disorder treatment for residents through screening, crisis intervention, outpatient care, and residential treatment
Guidance for Providers Supporting Pregnant Patients
Providers are often one of the few consistent and trusted points of contact during pregnancy, placing them in a unique position to support safety and well-being. Even small, intentional changes in how conversations begin can significantly increase trust and reduce risk.
Whenever possible, conversations about safety and substance use should happen in private, without partners, family members, or friends present. Normalizing these questions – such as explaining that violence and substance use are common concerns and that all patients are asked – can help reduce fear and stigma. Offering choices is also critical. Rather than directing a patient toward a specific action, providers can support autonomy by asking whether they would like immediate help or simply information to take with them.
At the same time, some approaches can unintentionally cause harm. Threats, shame, or ultimatums – particularly around reporting or treatment – can damage trust and increase danger. Providers should also avoid promising confidentiality that they cannot legally guarantee. Trauma-informed, patient-centered care that prioritizes safety, choice, and dignity is key.
A Closing Note
If you’re pregnant and dealing with domestic violence, substance use, or both, you are worthy of support and safety. Reaching out doesn’t mean you have to have all the answers. Start with one conversation, one call, or one visit.