Substance misuse is a complex issue, fraught with many challenges and inequalities for those affected; most of these are as a result not of the substances themselves, but of the underlying web of socioeconomic problems associated. Whilst the literature suggests that pregnancy may be a 'window of opportunity' for substance misusing women, it also suggests that there are several barriers to women engaging with health care. One of these is the fear of being judged and stigmatised by healthcare professionals. This literature review looks at research in the field of substance misuse in pregnancy, focusing on the 'stigmatisation' of pregnant drug users by healthcare professionals, illustrating the potential impact of this upon care.