The nationwide incidence of drug abuse during pregnancy is increasing, but has not been described in our geographic area. Beginning August 1, 1989, all women admitted to the Obstetrical Service at the Metropolitan Nashville General Hospital were to have their urine tested for drugs. In the 11-month study period, 962 women were delivered of neonates, and 631 were actually screened. Those under 18 years of age seldom tested positive for either cocaine or marijuana, regardless of race or marital status. Overall, white subjects were significantly more likely to have cannabinoid metabolites detected in the urine and blacks were more likely to test positive for cocaine use, but neither drug was found in married blacks. Although gravidity was significantly higher in the group testing positive for cocaine, so was parity. Thus, abortion did not correlate with cocaine use.