OBJECTIVE : To identify undergraduate and postgraduate student midwives' attitudes towards women using licit and illicit substances during pregnancy. BACKGROUND : Literature shows that globally, substance misuse during pregnancy is growing rapidly. Women who use substances during their pregnancy have specific healthcare needs and require midwives to demonstrate positive attitudes to improve appointment compliance and treatment completion. METHODS : A cross-sectional quantitative survey design was used. A total of 42 surveys were retained for full data analysis. RESULTS : Of the 42 participants, 22 were undergraduate midwifery students and 20 were postgraduate midwifery students. The results revealed that both undergraduate and postgraduate students had positive attitudes towards women who used substances during pregnancy. Specifically, postgraduate students, with 1-2 years' experience looking after pregnant women, had the most positive attitudes towards substance use in pregnancy. CONCLUSIONS : This study revealed that undergraduate and postgraduate midwifery students have positive attitudes towards women who misuse illicit and licit substances, which is important for providing quality care upon qualification as a registered midwife. It is essential that midwifery students, who will go on to qualify as registered midwives, are non-judgmental and positive to ensure adequate antenatal care and regular antenatal attendance so maternal and fetal wellbeing can be better managed.