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Drug and Alcohol Use During Pregnancy

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Using drugs or drinking alcohol while pregnant can create a number of health issues for both mother and child. This can affect a growing fetus because substances travel easily from the placenta, leaving the potential for harm.4

While not all women who take a substance are misusing, it’s important to understand how drugs and alcohol affect a woman and her baby during pregnancy to avoid potential adverse reactions or complications. Some women take prescription medications to help manage other health conditions, which should be addressed with a doctor.2

This article will outline the potential risks of using substances while pregnant, including the effects of substance abuse during pregnancy.

Alcohol Use During Pregnancy

Even a small amount of alcohol consumed during pregnancy can place an unborn baby at risk, according to the National Institute on Alcohol Abuse and Alcoholism.8

Drinking alcohol can increase your risk of miscarriage and may result in a number of development issues in your child like fetal alcohol syndrome (FAS)—the most severe example on the spectrum of fetal alcohol disorders.3 All fetal alcohol spectrum disorders involve negative consequences affecting the physical, mental, and behavioral health of your child.3

Though there is no safe level of alcohol consumption, many pregnant women consume at least some alcohol during this time, believing that a small number of drinks will be safe.

Cocaine and Pregnancy

Tracking the negative effects of cocaine use during pregnancy is a difficult task. This may be more difficult because women who misuse cocaine often have poor nutrition and inadequate prenatal care. People who use cocaine also tend to use the drug in combination with other substances like alcohol, making it hard to determine precisely which substance is responsible for the harmful effects on the fetus.4

Cocaine can exacerbate the normal cardiovascular changes you experience during pregnancy.4 Women consuming the cocaine may experience severe hypertension, seizures, migraines, and separation of the placenta from the uterus. If the placenta and uterus separate,  it can affect the mother’s ability to carry her baby to term.4

Heroin and Pregnancy

Using an illicit drug like heroin also significantly increases your baby’s risk of developing neonatal abstinence syndrome shortly after birth as well as sudden infant death syndrome (SIDS), also referred to as crib death.

Marijuana and Pregnancy

Contrary to popular belief, marijuana can be harmful and should be avoided when trying to conceive, during pregnancy, and while breastfeeding.4 While there is limited evidence on how marijuana use can affect a developing fetus, several studies suggest that its use may be associated with impaired fetal development, rare forms of cancer, premature birth, and low body weight at birth.

MDMA (Ecstasy) and Pregnancy

Studies suggest that fetal MDMA exposure during the first trimester can lead to long-term memory problems and impaired learning, as well as movement and coordination problems in the child.4 There have also been cases where babies exposed to MDMA while in utero developed cardiovascular anomalies and musculoskeletal problems.

Meth and Pregnancy

It has been reported that exposing a fetus to meth can result in several long-term health issues, including issues with cognitive skills, physical dexterity, and behavior. Mental health problems including increased depression, anxiety, and social isolation have been reported in children exposed to meth in the womb.4

Pregnant women using meth may be at risk of high blood pressure, placental abruption, and premature delivery.4

Painkillers and Pregnancy

Pregnant woman holding painkiller pills

Painkiller use during pregnancy, even if these medications were prescribed by your doctor before conception, can be harmful to your developing fetus. Opioid painkiller exposure to a fetus may be linked to excessive fluid in your baby’s brain, abdominal wall defects, glaucoma, and congenital heart defects.

Since many painkillers are chemically similar to heroin, the mother and child can experience many of the same risks. Children may be born with NAS, experiencing painful withdrawal symptoms after birth.

Cigarettes and Pregnancy

Cigarettes contain harmful chemicals that can negatively impact a developing baby’s brain and can limit the amount of oxygen being received by the fetus. Also, the impact of nicotine on a developing baby is greater than the impact on the mother. According to the National Institute on Drug Abuse, nicotine concentration is up to 15% higher in the baby’s blood than the mother’s.4

Exposing your unborn baby to the tar, nicotine, and carbon monoxide in cigarette smoke can also result in a number of health issues after birth. These can include respiratory issues, cerebral palsy, and problems with eyesight and hearing.

Being around others that smoke can affect your child, resulting in lower birth weight, increased likelihood of developing a respiratory illness, and a higher risk of sudden infant death syndrome (SIDS).3

Treatment for Drug Addiction

If you’re struggling with drug or alcohol addiction before or during pregnancy, help available. Getting help as early as possible will increase your chances of having a healthy baby and staying healthy and safe yourself.

You have a number of treatment options to choose from. Each option represents a unique set of interventions provided in settings that range in intensity and duration. The most effective treatment will address your substance use, mental health, physical health, and reproductive status.5

The first step towards treatment for many is detoxification and medically managed withdrawal.5 During this process, a team of medical professionals will monitor your vitals and administer medications as needed to add comfort and safety to you and your child while the substance leaves your body.5 Depending on the drug used and the severity of addiction, you can detox in one of a variety of settings, described below.5,6,7

Inpatient/Residential Treatment

Inpatient and residential drug and alcohol treatment facilities require a person to live at the center during treatment. These options are generally more intensive forms of treatment, as they provide 24-hour care, supervision, and structure. Inpatient/residential settings can be a specialized unit in a hospital environment or a facility that closely resembles a home.

Inpatient/residential treatment options can last for days, weeks, or months to assist you as you recover and get as healthy for the wellbeing of you and your child.

Outpatient Treatment

Outpatient programs include those in  which a person lives at home during treatment and visits the treatment facility throughout the week. Outpatient treatment provides a lower intensity of care than inpatient, which is appropriate for people with strong community support or those who have previously completed another treatment program. Like inpatient/residential programs, outpatient treatments can take several forms:9

  • Partial hospitalization programs (PHPs) that offer care 5 days per week for about 6 hours each day (the highest level of outpatient care).
  • Intensive outpatient programs (IOPs) that provide about 10 hours of weekly treatment divided over 2 or 3 days.
  • Standard outpatient usually includes weekly therapy sessions lasting approximately an hour.

Both inpatient and outpatient treatments can offer individual, group, and family therapy using techniques like:5,6

  • Contingency management (CM)—Attempts to offer positive reinforcement and desired rewards to encourage sobriety and healthy behaviors.
  • Motivational interviewing (MI)Strives to build the desire for change within the person by resolving doubt and uncertainty.
  • Cognitive-behavioral therapy (CBT)Works to identify the thoughts, feelings, and behaviors that result in substance abuse before learning coping skills to change old patterns.
Pregnant woman talking to male doctor

Treatments may include medication management options beyond those used during detoxification.5 For example, methadone (a prescription opioid medication used to limit withdrawal and reduce cravings for opioids) paired with behavioral therapies and strong prenatal care can reduce harm to the mother and baby.6 Though this treatment is used in practice, it should be noted that there are no federally approved opioid treatment medications for pregnant women.5

When you begin the process of recovery, a treatment support advisor will let you know which option is the best choice for you once they assess your situation. You may even be able to find a rehab center that specializes in substance abuse among pregnant women.

Professional addiction treatment options, like the ones listed above, all share the ability to improve outcomes for those that decide to begin their journey toward recovery.5

Remember, when you’re carrying a child, it’s not just your own health you need to think about. Give your child the best chance at life by getting clean and sober once and for all. If you need help finding treatment for drug or alcohol use during pregnancy, contact the caring admissions navigators at American Addiction Centers at 1-888-744-0069 . We are available 24/7 to listen and take your call so you can get started on the road to recovery.


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Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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