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Pregnant or Newly Parenting with Substance Use

The Families in Recovery (FIR) Program is the first in Canada to care for women who use substances and their newborns exposed to substances in a single unit.

We provide specialized services for women with substance use: 

FIR Square is a Combined Care Unit that provides care to women using substances and infants exposed to these substances. A multidisciplinary team will help you and your baby stabilize safely. We provide care and support to you throughout your pregnancy and afterward. We provide support to you in your transition back to your community after giving birth.  

Our goals

  • To empower women in their healthcare experience and ability to parent safely and identify supports, resources and connections with self, culture, and community
  • To reduce substance use and related behaviours that may cause harm to women and their newborns
  • Support pregnant people with perinatal substance use in addressing social determinants of health impacting their recovery
  • To support families in their recovery journey in a compassionate, caring, trauma-informed and culturally safe way, respecting and supporting growth and whether to parent and offering harm reduction in a recovery-oriented program.  The FIR program respects the long history and impacts of colonialism for many families and works to support other services in supporting parenting and minimizing child removals as a last resort.
  • To improve perinatal maternal outcomes: including decreased maternal mortality, decreased overdose risk and decreased impacts of medical and mental health illnesses 
  • To improve perinatal infant outcomes: including increased infant birth weights, improved growth and development of newborns, reduced impacts of Fetal Alcohol Syndrome (FAS) and Neonatal Opiate Withdrawal, and decreased vertical (maternal-child) transmission of HIV and Hepatitis C
  • To increase the number of women seeking recovery and their readiness to enter treatment.

Our team

Our multidisciplinary team of physicians, specialized nurses, a social worker, an addictions counsellor, a nutritionist, a recreational therapist and art therapist  provide the care.  


Our team assists substance-using pregnant and early-postpartum women achieve an optimum health to minimize the effects of alcohol, drugs, malnutrition, and neglect on themselves and their infants. We have five antepartum and six postpartum beds for women wishing to stabilize or withdraw from drug use during pregnancy. There is also a centralized nursery for babies in need of specialized treatment.

We help women and their newborns stabilize and withdraw from substances, keeping mothers and babies together whenever possible and continuing to provide care from antepartum to postpartum and between hospital and community.

Women at Fir Square have access to counseling and instruction to enhance critical life skills, parenting techniques, and coping mechanisms. Babies receive specialized care that meets their needs if withdrawing from prenatal substance exposure to ensure the healthiest possible start. Babies room with their mothers on the ward.

Our philosophy of care is one of harm reduction. Our aim is to help reduce substance use and risky behaviors that can cause harm to mothers and their babies. We support Mothers and their babies to safely stay together after they leave hospital, and help them to gain confidence with parenting.

We offer alcohol and drug counseling, assessment and support as well as a referral service as needed.

  • Caring, non-judgmental support
  • Advocate
  • Assistance with finding housing
  • Referrals to community services as needed
  • Access to medical care
  • Parenting groups
  • Recreational and music therapy
  • A First Nations Advocate available
  • Spiritual Care

Working within a model of woman centered care, women participate and guide every aspect of their care and discharge planning.

Women and their babies are kept together on the ward, and women learn to care for their baby if the baby is withdrawing.

The FIR Triage Protocol was created in collaboration with the FIR interdisciplinary team, Sheway and the Provincial Perinatal Substance Use team. The purpose of the Triage Protocol is to provide the parameters in which equal access to care at FIR is provided to individuals who require and will benefit from services at FIR. This process will help connect women to care that are not admitted on the unit. 

‎The FIR Patient Orientation Guide provides new patient information and resources to support newly admitted pregnant women in preparation for labour and delivery and afterbirth care.


We work in close partnership with community agencies such as the Sheway Downtown Eastside program providing support and prenatal care to pregnant substance-using women and women with children up to 18 months of age, the Ministry for Children and Family Development, and the alcohol and drug treatment system.

Research & Evaluation

Evaluation is ongoing. Research is looking at three month outcomes.

Please contact us with any research inquiries:

Shanlea Gordon
Research Project Manager, FIR Unit, BC Women's Hospital + Health Centre 

Provincial Outreach

The physicians and staff are available as a resource and for consultation and education in your community.


Self Referrals

You may self-refer. Please call the unit at 604-875-2229 and ask for the Patient Care Coordinator. Alternatively, you can fax us the referral form to 604-875-2221.


Physicians wishing to refer a woman may call the unit at 604-875-2229 or by faxing us the referral form. 

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SOURCE: Pregnant or Newly Parenting with Substance Use ( )
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