Maternal Cocaine Use and Infant Survival: Interrogating the Intersection of Race, Class, and Gender

Analyzing the 1988 National Maternal and Infant Health Survey, we find that access to prenatal care, as a component of a hostile environment, is the strongest determinant of prenatal care use when controlling for background characteristics, maternal fertility variables, and polydrug use. We believe this conceptualization is illuminated by theoretical discussion of the ways that race, class and gender intersect to affect and differentiate experiences of individuals and groups and that our use of hostile environment as a construct provides an example of a way to operationalize the intersection of race, class and gender in quantitative research. Findings lay the foundation for future research that will examine inadequate prenatal care as an endogenous variable in the hostile environment-birth outcome relationship, particularly for women of color and those who have used drugs during their pregnancy.