African Americans are disproportionately affected by fetal alcohol exposure. African Americans have the second highest incidence of FAS in the United States. Only Native Americans have higher incidence (Abel, 1995; Checky, n.d.). In addition, FAS incidence among African Americans is estimated to be seven to ten times higher than in Caucasian counterparts (Abel, 1995; Checky, n.d.; Graves, 2002; May & Gossage, 2001; National Institute on Alcohol Abuse & Alcoholism, 1994).

Caetano, Clark and Tam (1998) found that a complicated mesh of individual attributes, environmental factors, and cultural characteristics affect a person’s decision to quit drinking. Approximately two-thirds of women who report drinking alcohol prior to pregnancy spontaneously quit upon recognition of their pregnancy status (Curry, Grothaus, Lando, McBride, & Pirie, 2000; Day, Goldschmidt & Lucas, 2003; Ockene, Ma, Pbert, Goins, & Stoddard Zapka, 2002). Many factors contribute to abstinence. One factor that may influence sobriety during pregnancy is a woman’s ethnic cultural background. Compared to Caucasian women, African American/Black women are more likely to continue drinking throughout pregnancy (Lucas et al., 2003).

A limited number of research studies have addressed alcohol consumption patterns among women of different ethnicities. Ethnic differences influence social norms and beliefs; cultural differences, religious practices and beliefs, and social roles all influence drinking patterns (Collins & McNair, n.d.; Herd & Grube, 1996). Peindl (1992) in an unpublished doctoral dissertation cited in Lucas et al. (2003) found that African American women were more likely to continue drinking during pregnancy. Ockene et al. (2002) was the only study identified that indicated the rate of spontaneous cessation among pregnant African American/Black women. In this study 80% (57 of 71 respondents) of the Black women in the study spontaneously quit drinking. Okene et al. suggested that “the women who gave up alcohol may have been light or moderate alcohol users, rather than addicted” (p. 157). No other study was found that discussed possible reasons for cessation.

There is a need to gain more understanding about factors that influence abstinence from alcohol use during pregnancy among women who self identify as African American or Black. For simplicity in describing participants the term Black will be used which includes those who self identified as African American, Black, or mixed race. There were two primary focuses for our study. One was to identify factors that influence the intention to quit drinking alcohol during pregnancy. The second was to investigate the differences between Black women who quit drinking during pregnancy and those who continue to drink. Ajzen’s (1991) theory of planned behavior provided a framework to address these two issues.

Ajzen postulates that intention to engage in a behavior is dependent upon (a) one’s attitude toward the behavior, (b) the impact of subjective norms, and (c) perceived control — that is, the perceived ability to execute the behavior.