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Growing recognition of gender-specific disparities in mental health has led to increased attention and investment in behavioural health services for women, including care for substance use disorders (SUD). As these efforts expand, obstetrician-gynaecologists (OB/GYNs)—who provide care to two-thirds of women in the USA annually—are uniquely positioned to integrate behavioural health services into routine visits.1 For one in five women, their OB/GYN serves as their main point of contact within the healthcare system.2 These longitudinal relationships and regularity of visits across the life course create a critical and often underutilised opportunity: embedding substance use screening and interventions into OB/GYN care.