Substance Use in Pregnancy

Substance exposure in pregnancy is both a maternal medication-safety issue and a fetal–newborn health issue. The nurse's aim is to reduce harmful exposure without creating a second danger through untreated withdrawal, overdose, or interruption of effective therapy. Risk is not binary. The substance, amount, frequency, timing, route, co-exposures, and the pregnant person's overall health all affect the clinical picture. A disclosure therefore calls for focused assessment and coordinated support, not assumptions about the parent or the fetus. Use person-first, non-stigmatizing language: "a person who uses alcohol", "a newborn with neonatal opioid withdrawal syndrome (NOWS)", never labels such as "addict" or "addicted baby". The central medication distinction is this: opioid use disorder is treated with opioid agonist therapy (OAT) during pregnancy, whereas alcohol, cannabis, tobacco, and stimulant exposure call for counselling, practical support, and referral. A newborn may still develop opioid withdrawal despite appropriate maternal treatment; that predictable possibility is monitored and treated, and is not a reason to stop therapy. Canadian sources lead this lesson: the national CRISM opioid use disorder guideline (2024 update), the Canadian Paediatric Society (CPS) statement...