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Pregnancy and Substance Use:
A Harm Reduction Toolkit

created in collaboration with
We Care Daily Clinics

and F.I.R.S.T. Clinic

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This webpage and resource are UNDER CONSTRUCTION

This toolkit is a resource for all in Washington State and its tribal nations who care for - and are affected by - substance use disorders. 

Collectively, we hope to dismantle the stigma and discrimination around substance use in pregnancy.

It is created in DEDICATION to...

go directly to the full toolkit

Interested in creating a toolkit for your community?
Email Erika and Joelle

Do You have questions about this Washington toolkit?

Email Tiffanie Columbini, CPC

Taila AyAy, JD

DOWNLOAD the toolkit by sections

How to Use These Materials


This information is intended for use by pregnant and parenting people who use drugs, their loved ones, and 
their service providers. 

Our goal is to promote the overall health and wellbeing 
of pregnant people who use substances and their families.


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Build Your Care Team

  • My Medical Providers

  • My Doula

  • My Peer Support Specialists

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Quality Perinatal Care is Your Right

  • Substance Use and Substance Use Disorders

  • Unconditional Positive Regard

  • Motivational Interviewing

  • Respectful Language

  • Stigma versus Pride

  • Trauma-Informed Care

  • Gender-Inclusive Care

  • Continuing a Pregnancy

  • Ending a Pregnancy

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Harm Reduction


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Information on 6 classes of substances:


  • Alcohol and Pregnancy

  • Alcohol and Lactation

  • Treatments for Alcohol Use Disorder

  • Alcohol Withdrawal

  • Resources and Tools




  • Benzodiazepines and Pregnancy

  • Benzodiazepines and Lactation

  • Treatments for Benzodiazepines Dependence




  • Cannabis and Pregnancy

  • Cannabis and Lactation

  • Treatments for Cannabis Use Disorder

  • Cannabis Laws in Illinois

  • Resources and Tools




  • Opioids and Pregnancy

  • Opioids and Lactation

  • Treatments for Opioid Use Disorder

  • Naltrexone

  • Neonatal Opioid Withdrawal

  • Detox

  • Overdose and Pregnancy

  • Contamination of the Opioid Supply

  • Resources and Tools




  • Stimulants and Pregnancy

  • Stimulants and Lactation

  • High Blood Pressure

  • Treatments for Stimulant Use Disorder

  • Resources and Tools



Tobacco & Nicotine

  • Tobacco & Nicotine and Pregnancy

  • Tobacco & Nicotine and Lactation

  • Children and Smoke Exposure

  • Treatments for Nicotine Dependence and Smoking Cessation

  • Vaping and e-Cigarettes as Harm Reduction

  • Resources and Tools

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Navigating the Health Care and Legal Systems

  • Building a Relationship with Providers

  • Drug Testing and Informed Consent

  • Types of Drug Testing

  • Disclosure

  • Making a Plan

  • After Your Baby is Born

  • If There are Problems

  • Federal Legislation that May Affect You - CAPTA

  • Advocating for Yourself

  • Plans of Safe Care

  • Washington Laws and Statutes

  • Finding Help Where You Live

  • If You are Accused of Abuse or Neglect

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Supplemental Resource:

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Prenatal Care

  • Getting Insurance

  • My Pregnancy worksheets

  • Types of Pregnancy Providers

  • The Role of Doulas

  • Care Coordination

  • Nutrition

  • Routine Prenatal Care

  • Warning Signs

  • Emergency Complications

  • Routine Tests

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Supplemental Resource:


My Pregnancy worksheets

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Labor and Childbirth

  • My Birth Plan

  • Addressing Bias and Stigma

  • Pros and Cons of Various Forms of Pain Management

  • Medication-Induced Nausea

  • Complementary and Alternative Medicine Interventions

  • Low Tech Interventions

  • Postpartum Pain Management

  • Nonpharmacological Pain Management

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My Birth Plan and My Pain Management Plan worksheets

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Postpartum Care

  • The Risks of Overdose

  • Medical Racism

  • Breast/Chestfeeding and Human Milk

  • Drug Use and Human Milk - Legal and Child Welfare Considerations

  • Contraception Options

  • Contraception Coverage

  • Family Leave in Illinois

  • Pregnancy Rights in Illinois

  • Psychosocial Support and Perinatal Mood and Anxiety Disorders (PMADs)

  • Resources and Tools

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"Pregnancy and Substance Use: A Harm Reduction Toolkit" was originally created in collaboration with the National Harm Reduction Coalition and featured resources for those living in New York state.
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