Guide to accurate and compassionate communications on drug and alcohol use during pregnancy

The stakes for how we talk about pregnancy and substance use are incredibly high.

Stigmatizing language contributes to harmful narratives that keep people from getting the treatment and support they need for themselves and their families. Racist and sexist narratives about pregnant people who use substances and their children contribute to the disproportionate criminalization and separation of Black and Indigenous families by child welfare services. Those injustices reverberate from state legislatures to doctors’ offices to the nightly news.

We have a responsibility to do better, using an approach that respects people’s journeys and elevates effective solutions.

This resource offers guidance that promotes health and well-being, is grounded in evidence, and tells stories of pregnant people who use drugs and alcohol with compassion, humility and accuracy.

If you have questions or would like to connect with an expert, contact Rebecca Griffin.

Download the 1-page reference guide


  • Heather Briscoe, MD, UCSF Department of Pediatrics
  • Elise Buchheit, MSN, RNC-OB, SSM Health-St. Louis
  • Alena Chavez, Training in Early Abortion for Comprehensive Healthcare
  • Rebecca Griffin, UCSF Bixby Center for Global Reproductive Health
  • Cynthia Gutierrez, UCSF Department of Obstetrics, Gynecology, & Reproductive Sciences
  • Theresa James, MSW, LGSW, Mille Lacs Band Family Healing to Wellness Court
  • Joyce McMillan, JMAC for Families
  • Virali Modi-Parekh, Advancing New Standards in Reproductive Health
  • Lauren D. Oshman, MD, MPH, FAAFP, University of Michigan Family Medicine
  • Sarah Roberts, DrPH, Advancing New Standards in Reproductive Health, UCSF Department of Obstetrics, Gynecology, & Reproductive Sciences
  • Dominika Seidman, MD, MAS, UCSF Department of Obstetrics, Gynecology, & Reproductive Sciences
  • Mishka Terplan, MD, MPH, FACOG, DFASAM, Friends Research Institute
  • Erinma Ukoha, MD, MPH, FACOG, Columbia University Department of Obstetrics & Gynecology
  • Jeanette Vega, Rise Magazine
  • Lauren Wranosky, MSW, Pregnancy Justice
  • Tricia Wright, MD, MS, FACOG, DFASAM, UCSF Department of Obstetrics, Gynecology & Reproductive Sciences