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Illicit opioid use is a growing public health emergency and is associated with adverse medical and social outcomes. Opioid use in the pregnant population is increasing globally, and optimal management incorporates opioid substitution programs with improved concurrent engagement in medical care. The two main drugs used in opioid substitution programs are methadone and buprenorphine. Methadone has been used since the 1970s and provides treatment stability leading to improved engagement with obstetric services. Buprenorphine is a newer treatment, has greater dosing flexibility, and may be associated with fewer neonatal adverse effects. Direct comparisons of methadone and buprenorphine treatments are limited but suggest that buprenorphine is associated with less severe neonatal withdrawal; however, it is not universally well-tolerated and tends to be prescribed to less severely affected mothers. Given the lack of clear evidence to support one opioid substitution therapy over another, the principal aim of therapy should be to stabilize treatment and promote more comprehensive engagement with multidisciplinary services.

Background: Surgery-related adverse events remain\ud a significant and often under-reported problem. In\ud a recent study, the introduction of a perioperative\ud checklist by the WHO reduced deaths and\ud complications by 46% and 36% respectively. The\ud authors wished to evaluate the introduction of\ud a surgical safety checklist in a busy obstetric tertiary\ud referral centre by assessing staff attitudes, checklist\ud compliance and effects upon patients.\ud Methods: A questionnaire-based assessment was\ud performed on staff working in obstetric theatres before\ud and after the introduction of the surgical safety\ud checklist. Checklist compliance was assessed at\ud 3 months and 1 year. Patients were asked questions\ud relating to the performance of the surgical safety\ud checklist in order to evaluate any anxiety caused.\ud Results: Non-medical staff were significantly more\ud likely than medical staff to feel familiar with other team\ud members both before (p

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