Maybe I'll just describe some of the response to pregnancy in drug-using women in Vancouver.
We have, in the inner city, a specialized group of nurses, doctors and outreach workers to track and bring prenatal care to our drug-using ladies, and to offer them treatment at B.C. Women's Hospital on a specialized ward called FIR where they can be and are stabilized. They often go back and forth, but they're always known and tracked, and the ward is where they can deliver their children as safely as possible, with rooming in and support for the baby in the withdrawal phase as well.
It's a long-recognized problem for us in our community and there is a lot of effort being made to support women who are pregnant and who happen to be using substances. That said, a number of my patients, particularly those who are HIV-positive and for whom intensity is absolutely essential to prevent transmission to the infant, we can still have them deliver on the sidewalk. However, usually we're there.
It's an intense process and we try to keep people unpregnant as much as possible, but there is a specialized service for them that seems to be quite effective.