Within Saskatoon, Canada, and globally, there continues to be oppressive practices that contribute to women being afraid to access prenatal and childbirth related services, especially those who use substances while pregnant. Women who use substances while pregnant are often made to feel shame, inadequacy, and are given few options regarding their care. To break this cycle, our health care system needs to better understand the unique needs of women who use substances while pregnant, such as barriers to childcare and transportation, and be mindful of the interconnectedness of structural, interpersonal, and intergenerational violence. Our health care system needs to take a trauma-informed approach to reduce risks of re-traumatization and postnatal post-traumatic stress disorder (PTSD). A quality improvement project was completed to better understand how health services and providers could improve and become more traumainformed when working with women who use substances while pregnant. Four themes emerged from the quality improvement project which were: education on methadone, fears of child apprehension and judgement, feeling defeated and loss of hope, and missed opportunities. Some of the positive experiences the women from the project experienced were highlighted. Gaps in services will also be discussed thus reinforcing the need for our healthcare system to take a trauma-informed care approach for women who use substances while pregnant.