Background: Although the number of women who use illicit drugs in pregnancy is small, the burden of disease is large. Previous research has focused primarily on neonatal outcomes. This paper reports the findings of a pilot study measuring the obstetrical health, antenatal care and psychosocial characteristics of substance using pregnant women attending a public antenatal clinic.

Method: Self-report measures of obstetrical health, antenatal care, physical and mental functioning, substance use and exposure to violence were assessed via face-to-face interviews.

Results: This was a markedly disadvantaged group of women. The mean number of weeks pregnant at first antenatal visit was 17 weeks, 75% of the women experienced problems with their antenatal care and only 25% of the women reported wanting to become pregnant. Almost three quarters of the women had used nicotine in the past month; cannabis was the most prevalent illicit drug used in the past month, followed by heroin. Less than three quarters of the women were currently enrolled in opioid pharmacotherapy. The women scored poorly on measures of general physical, social and mental functioning including symptoms of depression and anxiety.

Conclusions: This pilot study is of major significance as it documents for the first time the maternal health of women who use substances during pregnancy, rather than focusing solely on the foetus/neonate. Overall, the profile of these women is one of extreme disadvantage and poor health. Unique issues around antenatal care were identified: a chaotic lifestyle coupled with lack of childcare, money and transport leaves them vulnerable to a range of potentially life-threatening obstetric and general health conditions. The challenge is therefore to develop, implement, and resource innovative and effective multi-sectoral systems that educate women about family planning at an early age and provide timely and effective antenatal and follow-up care for the women and infants alike.