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Pregnancy, Drugs & Alcohol

Families in Recovery Combined Care Service (FIR) 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 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 reduce substance use and related risky behaviours that cause harm to women and their newborns
  • To improve perinatal outcomes, including increased infant birth weights; improve growth and development; reduced incidence of Fetal Alcohol Syndrome/Neonatal Alcohol Syndrome (FAS/NAS) babies, HIV+ babies, and Sudden Infant Death Syndrome (SIDS).
  • To increase the percentage of mothers who are able to safely retain custody of their babies after birth and throughout the child's early years by improving parenting skills and understanding of safe home environments, and gaining confidence with mother and infant interactions and play.
  • To increase the numbers of women seeking recovery and their readiness to enter treatment.
  • To increase access to a range of medical and community services for substance-using women.

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.


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.

Provincial Outreach

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


Call 604-875-2229 and ask for the charge nurse.

Outpatient Clinic

There is a weekly outpatient clinic on Thursday afternoons from 1 p.m. to 4 p.m. 

The doctors at this clinic are able to provide methadone.

Women may self refer. Lack of a doctor, ID or medical card is not a barrier to attending the clinic.


Physicians wishing to refer a woman may call the Perinatal Addictions Team through paging at 604-875-2161, or they may call Kristen Ruddick, Program Manager at 604-875-2407, or Fir Square directly and ask for the Charge Nurse at 604-875-2229

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