Clinical Guidance for the Management of Substance Use in Pregnancy, Birth and the Postnatal Period

Summary

The Clinical Guidance for the Management of Substance Use in Pregnancy, Birth and the Postnatal Period summarises the guiding principles, professional practice and interventions used when working with pregnant women who use substances. The Guidance aims to support all people who work in an alcohol and other drug setting as well as those providing support to women in maternity settings to ensure consistency of care across the sector.

Key information covered within the guidance includes:

• The changing scope of substance use by pregnant women in NSW, such as the increased use of methamphetamine and prescription medication.
• Strategies for providing holistic, wrap around care and ongoing case management support to improve outcomes for women and babies.
• The management of neonatal withdrawal and toxicity from a range of substances beyond opioids.
• Guidance on how to support vulnerable populations, including women who are incarcerated, women who live in rural and remote communities, and Aboriginal women.
• Emerging evidence for treatments such as buprenorphine-naloxone and depot buprenorphine for opioid dependency.

Information within the Guidance aligns with other health initiatives in NSW and Australia, such as the Brighter Beginnings program, The First 2000 Days Framework, the Clinical Excellence Commission's Safer Baby Bundle, the National Fetal Alcohol Spectrum Disorder (FASD) Strategic Action Plan 2018–2028 and the Get Healthy in Pregnancy service.

The guidance is based on the best available evidence. It has been developed through a rigorous process in which experts reviewed international and Australian academic literature and achieved consensus on guidance for NSW health professionals.

This is the revised and updated version of the now rescinded GL2014_022 Clinical Guidelines for the Management of Substance Use During Pregnancy, Birth and the Postnatal Period and GL2013_008 Neonatal Abstinence Syndrome Guidelines.