Patients often try to conceal or understate their alcohol and illicit drug use; this also applies to mothers attending antenatal clinics. Questions about substance abuse should be direct in the attempt to create an open and confidential atmosphere. A pregnancy in a woman with substance abuse problems is always a high-risk pregnancy, and these women should be referred to a specialist substance abuse antenatal clinic as early as possible. Appropriate substance abuse treatment for a pregnant woman should be initiated without delay and with her consent.
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