Substance use in pregnancy is a complex and sensitive area of maternity care. In this episode of Talking O&G, host Dr Kasia Siwicki is joined by Dr Anna Clare (obstetrician gynaecologist and Chair of the Guideline Development Group), Dr Dan Wilson (GP and addiction medicine specialist), and Kerri Felemonow (social worker, Manager of The Women’s Alcohol and Drug Service Program at the Royal Women’s Hospital) to unpack the updated RANZCOG Clinical Guideline – Substance Use in Pregnancy (C-Obs 53). The conversation explores why the guideline was updated and what’s new, the role of non-stigmatising, person-centred language, and practical approaches to universal screening in antenatal care. The guests also discuss pharmacological and non-pharmacological supports for nicotine, alcohol, and opioid use, the importance of harm reduction strategies, and what supportive care looks like in practice, with a focus on providing trauma-informed and culturally safe care, particularly for Aboriginal, Torres Strait Islander, and Māori women. The episode investigates how holistic, multidisciplinary and community-led approaches can improve outcomes for mothers and babies. 🔗 Resources mentioned in this episode: Substance Use in Pregnancy (C-Obs 53) 📌 RANZCOG members can submit CPD at: https://shorturl.at/iq733 💬 If you found this episode valuable, please rate, review, subscribe, and share it with your colleagues. The views expressed are those of the speakers and may not reflect the official position of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).