In the last three months, I have encountered a substantial number of young women seeking pregnancy care who are actively using various substances.

Substance abuse during pregnancy is more prevalent than commonly realised but it is rather difficult to detect. This is because the signs and symptoms of this behaviour are often subtle, self-reports of substance use may be misleading or infrequently elicited, physicians may fail to routinely screen for use, and substance abusing pregnant women may seek little or no pre-natal care.

The four general categories of substances abused by pregnant women include: Central nervous system depressants -- alcohol, sedatives, anxiolytics and hypnotics; Stimulants -- cocaine and amphetamines; Opiates and hallucinogens -- lysergic acid diethylamide (LSD) and phencyclidine (PCP). With the exception of caffeine and nicotine, these substances are associated with both abuse and dependence disorders.

Many forget that when you are pregnant, you are not just "eating for two." You also breathe and drink for two, so if you smoke, use alcohol or take illegal drugs, so does your unborn baby. Sadly, it is with devastating effects.

Smoking passes nicotine and cancer-causing drugs to your baby, keeping it from getting nourishment and raises the risk of stillbirth or premature birth.

When it comes to alcohol, there is no known safe amount that a pregnant woman can drink. Alcohol can cause life-long physical and behavioural problems in children, including fetal alcohol syndrome.

Illegal drugs cause myriads of problems, including underweight babies, birth defects or withdrawal symptoms after birth.

If you are pregnant and you smoke, drink alcohol or do drugs, get help.