ABSTRACT
This chapter examines the nature, patterns, outcomes and treatments for the most commonly used substances in pregnancy in Australia and the United States (US); tobacco, alcohol, marijuana, opioids and methamphetamine. Women who are substance dependent and pregnant need to be treated in a respectful and non-judgemental manner, as emphasised here by Emma: Issues of child protection are, however, paramount. In the US, there remains one state that criminalises drug use during pregnancy; 18 states consider substance abuse during pregnancy to be child abuse under civil child-welfare statutes; and three states consider it grounds for civil commitment. All health services for pregnant women who are substance dependent should be non-judgemental and provided in a holistic framework that is centred around the woman's current priorities and needs, and grounded in evidence based policies and procedures. The chapter concludes with the implications of substance use in the perinatal period for clinical practice.
