Although women who abuse drugs and alcohol come from varied socioeconomic and ethnic backgrounds, many share a variety of psychosocial and psychiatric risk factors that may limit their capacities to be nurturing parents. in particular, substance-abusing women often have family histories of factors of substance abuse, childhood histories of sexual victimization, current involvement in violent partner relationships, and varied types of mental health problems. Such risk factors, which limit mothers' abilities to respond sensitively to their infants, may impact on the development of their children even more strongly than the teratological effects of drug exposure in utero. Pregnancy and the perinatal period, when mothers begin to establish critical early relationships with their infants, may be a particularly important time for mental health and parenting interventions with substance-abusing women.