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Supporting pregnant women who use alcohol or other drugs - A Guide for Primary Health Care Professionals




To prevent poor pregnancy outcomes, including conditions like Fetal Alcohol Spectrum Disorders, we must do more to provide treatment to pregnant women with problematic substance use. There is clear evidence that heavy and frequent use of alcohol or other drugs and associated lifestyle factors contribute to significant harm during pregnancy.
Health care professionals can make a substantial difference to the health of women and their babies by identifying and supporting women who use alcohol or other drugs during pregnancy. This Guide is intended for a range of primary health  care professionals including GPs, midwives, nurses, practice nurses, Aboriginal health care workers and sexual health workers. It is applicable to a wide range of health care settings. In any health care setting where pregnant women are seen, they should be asked, without judgement, about their alcohol, tobacco and other drug use and provided with access to appropriate treatment and support.
Evidence shows that well-coordinated and comprehensive support with early access to antenatal care and specialist alcohol or drug treatment can reduce harm and improve outcomes for pregnant women who have problematic alcohol and drug use, and their babies. 
Women can also benefit from preconception counselling to address problematic substance use prior to pregnancy. All women with problematic alcohol or drug use should be provided with advice about contraception.
The clinical information in this Guide is largely drawn from NSW Clinical Guidelines for the Management of Substance Use during Pregnancy, Birth and the Postnatal Period, which is the latest clinical guidance for management of drug and alcohol use in pregnancy. 
Health professionals should also consult relevant State and Territory legislation, policy and clinical guidelines. Links to useful documents are provided in Chapter 5 of this Guide.
This Guide also draws on a range of evidence from Australian and international studies about the best strategies to reduce the harms to women and children from alcohol and drug use in pregnancy.
This evidence is outlined and fully referenced in a report Supporting Pregnant Women who use Alcohol or other Drugs: a review of the evidence.

A quick guide to identifying women at risk from alcohol, smoking or other drug use during pregnancy for primary health care professionals is available here https://ndarc.med.unsw.edu.au/resource/quick-guide-identifying-women-risk-alcohol-smoking-or-other-drug-use-during-pregnancy and also attached as a PDf on this page.

There are already a range of projects, resources and tools available to health professionals to support their work in this area. Rather than replicating these, this Guide outlines the components of best practice care, describes important steps to take and directs health professionals to existing resources.