Pregnancy and Substance Abuse

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1 Pregnancy and Substance Abuse Introduction When you are pregnant, you are not just "eating for two." You also breathe and drink for two, so it is important to carefully consider what you put into your body. If you smoke, use alcohol or take illicit drugs, so does your unborn baby. If you are pregnant and you smoke, drink alcohol or use illicit drugs, treatment can help you quit. Your health care provider can recommend treatments to help you quit. This reference summary explains the effects of substance abuse on pregnancy. It discusses the effects of alcohol, tobacco and certain drugs on a developing baby. Pregnancy and Substance Abuse The placenta is an organ between the amniotic sac and the uterus. It grows with the baby during pregnancy. The baby gets nutrition from the placenta. The mother s blood delivers oxygen and nutrients to the baby s blood through the placenta. The mother s blood also removes waste from the baby s blood through the placenta. If you drink alcohol, smoke tobacco or use drugs when you are pregnant, the substances enter your bloodstream. They reach your developing baby through the placenta. An adult s body can break down toxins like alcohol faster than a fetus can. For example, if you drink alcohol while you are pregnant, your developing baby's blood alcohol levels will be higher than those in your body. The high levels of toxins can harm developing organs, including the brain. 1

2 Alcohol, tobacco and drugs can affect how an unborn baby develops. If you use these substances during your pregnancy, your baby may be born with serious health problems. These health problems may be permanent and affect your child for his or her entire life. Pregnancy and Alcohol Alcohol can harm your baby at any stage during a pregnancy. It can harm your baby before you even know that you are pregnant. Drinking alcohol during pregnancy can be very damaging. It prevents oxygen and nutrients from reaching your baby's developing tissues and organs, including the brain. This means that the tissues and organs may not develop normally. Drinking while pregnant can cause the baby to die. If the baby dies before the 20th week of pregnancy, it is called a miscarriage. The death is called a stillbirth if the baby dies after the 20th week of pregnancy. Drinking alcohol while pregnant can also cause Fetal Alcohol Spectrum Disorders, or FASDs. Fetal alcohol syndrome, or FAS, is the most serious type of FASD. FAS is not a single birth defect. It is a group of related problems. The problems caused by FAS vary from child to child. But the problems are irreversible. This means that they cannot be cured. FAS is a common cause of mental disability and learning disorders. The severity of mental problems varies. Signs of FAS may include irregular facial features, such as: A short, upturned nose. A smooth skin surface between the nose and upper lip. A thin upper lip. Small eyes. 2

3 Other symptoms of FAS are: Heart defects. Joint, limb and finger deformities. Poor coordination. Slow physical growth before and after birth. Small head and brain size. Vision or hearing problems. FAS can also cause abnormal behavior, including: A short attention span. Anxiety. Extreme nervousness. Hyperactivity. Poor impulse control. There is no amount of alcohol that is known to be safe to drink during pregnancy. The more you drink while pregnant, the greater the risk to your unborn baby. Pregnancy and Tobacco Smoking during pregnancy is also harmful. It exposes a baby to carbon monoxide. This limits the baby's supply of oxygen and the delivery of nutrients. Exposure to nicotine also increases a baby's heart rate and reduces his or her breathing movements. Between 20 and 30 percent of low birth weight babies are born to mothers who smoked during pregnancy. Smoking while pregnant has been linked to premature deliveries and infant deaths. Full-term babies of smokers are also at risk. These babies may be born with narrowed airways and low lung function. Breathing secondhand smoke during pregnancy can also affect your baby's health. Women who do not smoke but are exposed to secondhand smoke are at an increased risk of pregnancy loss. They are also at risk for having a baby who has birth defects or a low birth weight. 3

4 Smoking during pregnancy has been linked with other problems, as well. These include: Birth defects involving the heart, limbs, skull, muscles and other areas. Miscarriage or stillbirth. Preterm premature rupture of the membranes, or PPROM. Problems with the placenta. Vaginal bleeding. PPROM happens when the amniotic sac leaks or breaks before labor begins and before week 37 of pregnancy. The amniotic sac is the fluid-filled membrane that surrounds and cushions the baby during pregnancy. Smoking during pregnancy can also affect a baby after he or she is born, increasing the risk of: Asthma. Childhood obesity. Colic. Respiratory infections. Sudden infant death syndrome, or SIDS. SIDS is the sudden, unexplained death of an infant younger than one year old. Some research also suggests that smoking during pregnancy might affect a child's emotional development, behavior and ability to learn. Smoking during pregnancy may even affect the child's reproductive organs. Pregnancy and Drug Abuse Using illicit drugs is dangerous. If you use them while you are pregnant, it may cause many health problems for you and your baby. Some over-the-counter and prescription medications can also harm the baby. Tell your health care provider about all of the substances you ingest, smoke or inject. 4

5 A woman who uses drugs while pregnant is at risk for: Fluid in the lungs. Breathing problems. Heart problems. Seizures. Brain damage. Hallucinations. Stroke. Use of some illicit drugs while pregnant can cause: Miscarriage or stillbirth. Breech birth. Preeclampsia. Preeclampsia is high blood pressure that is a severe complication of pregnancy. It may also cause blurred vision, headaches, extreme swelling and greater than normal weight gain. Bleeding. Placenta abruptio. Placenta abruptio is the separation of the placenta from the uterus before a baby is delivered. This can lead to premature birth, low birth weight and major maternal blood loss. Coma. A baby born to a woman who has abused drugs while she is pregnant may be at risk for: Sudden Infant Death Syndrome, or SIDS. Strokes. Seizures. Deformed organs. Breathing problems. Heart problems. Weak muscles. 5

6 A baby born to a woman who has abused drugs may also be at risk for: Low birth weight. Premature birth. Certain types of cancer. Physical development problems. Learning and behavior problems. A baby that is born addicted to drugs may experience addiction withdrawal symptoms after birth. Side effects of withdrawal may include: Anxiety. Depression. Extreme tiredness. Problems sleeping. Strong cravings for the drug. Treatments Do no t drink alcohol, smoke or take drugs if you're trying to get pregnant. Stop abusing substances as soon as you know you are pregnant or if you think you may be pregnant. It is never too late to stop using these substances during your pregnancy. But the sooner you sto p, the better it is for your baby. Your health care provider can recommend treatments to help you quit drinking alcohol, smoking tobacco and using drugs. A health care provider can determine your level of dependence and create a treatment plan. Health care providers cannot diagnose FASDs. But they can help determine the risk of FAS. Tell your health care provider when you drank alcohol and how much you drank. If you smoke, the best way to give your baby a healthy start is to quit smoking. If you quit in the first four months of pregnancy, you might lower your risk of having a low birth weight baby. Your risk may be the same as that of a nonsmoking woman. 6

7 If you quit smoking during pregnancy, it can also reduce the risk of: Infant death. Premature birth. Pregnancy loss. Other complications. The safest way to quit smoking during pregnancy is without the aid of medicine. Start by asking your health care provider for advice. To stop using illicit drugs, treatments are available. The goals of treatment are to help a person: Learn how to fight the urges to use drugs again. Regain control of his or her life. When someone quits taking drugs and starts learning how to live life without them, it is called recovery. The first step in recovery is detoxification. Detoxification, or withdrawal therapy, helps you stop taking drugs in a safe way. It may involve slowly reducing how much of the drug you use. Therapy is also used to help a person overcome addiction. Different types of therapy are available, and often multiple types are used for a single person. Treatment programs are available that provide education and therapy sessions. These sessions may be done individually, in a group setting or with family members. Counseling can help you cope with cravings and provide strategies for avoiding relapse. Relapsing is when a person quits a drug but starts using again. People recovering from addiction often have one or more relapses along the way. Self-help groups are also a key part of treatment for many people. These groups focus on how drug addiction is a disease that requires ongoing treatment. It can also connect you to people who are in similar situations. A health care provider or counselor can help determine which type of treatment is best for each person. Concerned family members can also get in contact with a health care provider or counselor to try to help a loved one that is addicted to drugs. 7

8 Summary When you are pregnant, you are not just "eating for two." You also breathe and drink for two, so it is important to carefully consider what you put into your body. Do not drink alcohol, smoke or take drugs if you're trying to get pregnant. Stop abusing substances as soon as you know you are pregnant or if you think you may be pregnant. It is never too late to stop using these substances during your pregnancy. But the sooner you stop, the better it is for your baby. Your health care provider can recommend treatments to help you quit drinking alcohol, smoking tobacco and using drugs. A health care provider can determine your level of dependence and create a treatment plan. 8

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