Don?t be surprised if your OB-GYN wants to talk to you about your substance use. You?ve heard about the dangers of drinking while pregnant and seen the scary warnings about smoking?s effects on a fetus on cigarette packages, but with the legalization of marijuana and the growing opioid crisis, experts think it?s time to turn all those warnings into a bigger conversation.
The Society of Obstetricians and Gynaecologists of Canada (SOGC) have released new guidelines on substance use in pregnancy, recommending that healthcare providers ask all pregnant women about their past and current alcohol, nicotine and illicit and prescribed drug use. It?s an important conversation to have, because at least 11 percent of Canadian women report smoking or drinking when pregnant, while two percent are estimated to use marijuana and one percent take opioids. While drug testing could give doctors a quick answer, the SOGC discourages universal screening and says a woman?s consent should be required for any drug testing. Instead, ?Using open-ended, non-judgmental questioning is more likely to elicit disclosure of perinatal substance use,? say the guidelines. The SOGC?s recommendations seek to start the discussion so that OB-GYNs can counsel women on the effects of substance use?before, during and after pregnancy?and assist them in seeking help through harm-reduction strategies.

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