“Best practices” are strategies that experience and research show work well with different groups of people. (They are also sometimes called “better practices”, “promising practices”, or “evidence-based” practices.) When it comes to pregnant women who use substances, best practices that lead to healthier pregnancies include support from service providers that:

Practical supports make a big difference.Help women deal with their immediate needs and issues, even if that is not directly about her substance use. Substance use is closely connected to things like living in poverty, lack of good food, living in overcrowded, unsafe, or inadequate housing, and experiences of trauma, violence, and abuse. So, anything you do that helps pregnant women in their day-to-day lives will make an impact on a healthier pregnancy, even something as simple as driving a woman to appointments.


Here is a quote from a service provider in our community that describes how their program provides practical supports:

Audio Transcription:

“Our program offers drives, door prizes (fruit packs, meat packs, snack bags), food, clothes and other things for the baby. We want to make it really attractive for women to get involved. These women typically don’t have much family support, so the only support they have is us and maybe the nurses.”

Here are some ways service providers can use these best practices in their work with pregnant women who use substances:

  1. Provide encouragement and positive feedback about even the smallest changes.
    Many pregnant women who use substances are able to stop or significantly reduce their substance use when they are pregnant. If she isn’t able to quit using completely, talk about small steps she can take to cut back on her use.

  2. Find out more about specialized prenatal supports and services for women with substance abuse issues. These supports may or may not be available in your community. So you might have to find out if these supports exist elsewhere. Advocate for pregnant women and help to reduce any barriers to timely and effective care and supports.

  3. It's never too late to address substance use during pregnancy. Some women may be reluctant to discuss their substance use or to seek care and support. Give them time. Relationships take time to build.

  4. Ask and listen to her story. Create a safe environment for women to discuss substance use and to have their questions answered. Accept that substance use has powerful benefits in many situations. Your role as a sensitive, caring, and accepting service provider is one of the most important ways you can help reduce substance use in the lives of pregnant women. Women who have recovered from substance use say that one of the most important things that helped them heal was having a caring service ask about their substance use and listen in a non-judgemental manner to what they had to say. You might think you don’t have specific expertise about substance use. But this shouldn’t keep you from asking about it. It is important to remember that you already have the skills you need to have a conversation with a woman about her substance use. These skills are no different from the skills you use to help people with other problems. You need to be supportive, non-judgemental, encouraging, and hopeful. And make use of trauma-informed approaches. They are always the best ones to use with women. For more information about this topic, go to the Strategies section of this site, here.

    Here is a quote from a service provider in our community about the importance of listening:

    Audio Transcription:

    “Listen all the time, you don’t have to say anything, just listen and be there for them. Women know when you’re not listening and paying attention. But when you’re actually there listening and open to them, that’s what makes a difference.”

  5. Support women who are at-risk to self refer to child welfare services. Early support is more likely to lead to a positive outcome. Be honest and open about your child protection responsibilities after the baby is born if you have concerns about the baby’s safety and well-being. Legally, you do not have to call child protection during the prenatal period unless a woman has asked you to. But if you think child protection services are likely to be alerted later, it can be helpful for a woman to connect with them during her pregnancy and get the supports in place that will make it more likely for her to be able to parent her new baby. If you have a basis for building a stronger relationship with community partners, including child welfare, the long-term impacts will be more likely to be positive for pregnant women who use substances For more information about this topic, go to the Reflection section of this site, here: LINK to work to improve relationships with the child welfare system

  6. Examine your own beliefs and practices. Service providers should examine their own feelings about pregnant women and substance use and consider how best to support them. And they should always take into account the complexities of the lives and relationships of the women they serve. Find out ways you, your program, and community leaders can examine beliefs and practices. For more information about this topic, go to the Reflection section of this site, here