Although women using drug and alcohol services are at higher risk of unplanned pregnancies and poorer pregnancy outcomes than women in the general population, they are less likely to access mainstream sexual health services.

This UK audit found that few clients of treatment centres who were planning pregnancy were adopting preconceptual health-improvement measures, such as stopping smoking and taking folic acid. Although most of the women were not planning pregnancy, many were having unprotected sexual intercourse.

Services should break down taboos and stigma around discussing women’s pregnancy plans and their attitudes, increase pregnancy testing, assess sexual health needs and provide opportunities for discussion of the issues and education.