Social stigma against substance use and abuse during pregnancy is especially intense. Individuals who are addicted to drugs or alcohol become pregnant quite often, whether it’s due to contraception failure or the fact that substance abuse tends to increase impulsive behaviors and makes remembering hormonal contraceptives more difficult. No matter the reason, stigma and shame only create a greater chance that the pregnant person will hide her addiction rather than seek treatment, exposing both her and the fetus to greater harm and the risk of permanent injury or death. It’s essential that both information and health services be made available and convenient for pregnant individuals.
According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2013 National Survey on Drug Use and Health, among pregnant women age 15-44, 5.4 percent were illicit drug users, 9.4 percent used alcohol (2.3 percent reported binge drinking), and 15.4 percent smoked tobacco. In each category, substance use fell in later trimesters, but 12.8 percent of pregnant women were still smoking in their third trimester of pregnancy.
Anything the mother consumes during pregnancy is passed along to the fetus. Although there are some natural filtration systems in place to protect the child, excessive consumption of an intoxicant guarantees that it will reach the fetus and creates a high risk of permanent damage. Due to the fact that a fetus is in a rapid development state, any disruption is likely to have permanent and debilitating effects.
- Low birth weight
- Premature birth
- Increased chance of SIDS (sudden infant death syndrome)
- Neurological and congenital issues
- Developmental disabilities
- Increased chance of mental health and substance abuse problems later
At the same time, substance abuse while pregnant also puts the mother at risk. Pregnancy is hard on the body, and if something goes wrong, it can put the mother’s life in jeopardy. Common health problems in the mother include:
- High blood pressure
- Anxiety and/or depression
- Early or premature labor
- Skin infections
Due to increasingly strict legal regulations, women who struggle with addiction are also at risk for arrest and prosecution if it results in harm to the fetus. Women have been charged with child endangerment, assault, and even homicide if the child suffers health problems or dies before or soon after birth. With this on top of the stigma, stress and high levels of anxiety are commonly reported in women with substance use disorders who become pregnant.
Fetal Alcohol Syndrome
Fetal alcohol syndrome (FAS) refers to a group of symptoms that, when put together, indicate a certain condition caused by exposure to alcohol when in the womb. Heavy use of alcohol during pregnancy can cause children to be born with deformities, low birth weights, central nervous system issues, intellectual disabilities, and developmental disabilities.
It’s estimated that each year in the US, 5,000-12,000 infants are born with this syndrome. It’s considered to be one of the leading causes of preventable intellectual disability.
FAS is commonly associated with a characteristic set of facial features. The more severe the facial deformities, the more severe the case of FAS is considered to be. These include small eyes with drooping eyelids; a short, upturned nose; flat cheeks; small jaw; and a thin upper lip with flattened philtrum. These children tend to develop both gross and fine motor skills at a slower speed and have behavioral issues like hyperactivity and impulse control as well as cognitive issues, such as memory impairment, trouble with language, and learning disabilities. They may also develop seizures and hearing disorders.
Neonatal Abstinence Syndrome
Neonatal abstinence syndrome (NAS), like FAS, is caused by substance abuse during pregnancy. However, this condition refers a group of symptoms caused by exposure to opiates like heroin. Many prescription drugs can also cause this syndrome, including OxyContin, codeine, and buprenorphine.
NAS is essentially a set of withdrawal symptoms in the infant. When a pregnant person takes an opioid, the drug passes through the placenta and gets into the fetus’s system. Because opioids are so addictive and a fetus is so much more sensitive to intoxicants, addiction happens easily and rapidly. When the child is born, there is no more drug intake, and withdrawal symptoms appear.
- Blotchy skin
- Stuffy nose and sneezing
- Hyperactive reflexes
- Poor feeding
- Rapid breathing
These issues often require the infant to stay in the hospital and can last for up to six months. Doctors may try to wean the infant off the substance with a similar drug and may need to supplement feeding or provide intravenous fluids to prevent dangerous dehydration.
Using heroin during pregnancy can also cause birth defects, premature birth, low birth weight, and stillbirth, as well as increase the chance of SIDS. Heroin use is also associated with placental abruptions, a very serious condition in which the placenta separates from the uterine wall before birth. If severe, this can cut off oxygen and nutrients to the fetus and cause severe bleeding that threatens like life of both mother and child.
Methamphetamine and Pregnancy
Using meth at any point is dangerous, but doing so during pregnancy significantly increases the chances of rare defects in the fetus as well as rare pregnancy complications that can hurt both the fetus and the pregnant person.
According to a 2010 study, nearly a quarter of pregnant meth users have uncontrolled high blood pressure. While not normally an immediate concern in young people, this can be quite dangerous during pregnancy and lead to eclampsia – the second leading cause of death during pregnancy. Eclampsia is a certain type of seizure that happens to pregnant people; it can cause placental abruption, premature labor, and kidney, liver, and brain damage to the mother.
Meth use during pregnancy also significantly increases the chance of premature birth to around 50 percent, compared to 17 percent in the general population of pregnant mothers. It also increases the chance that the mother will have to deliver via C-section, which is a major surgery that includes an increased risk of infection and potentially lethal complications.
There is a wide range of severe health problems that a child can suffer if the mother takes meth while pregnant. These include:
- DNA damage: The free radicals present in methamphetamine can damage the actual DNA of a fetus due to the fact that protective enzymes have not yet developed. This can affect every aspect of development, including the development of major essential organs.
- Fetal stroke: Meth increases the blood pressure of whoever takes it. Due to the small size and developing bodies of fetuses, this drug can cause such an intense blood pressure increase that it can lead to strokes and brain hemorrhages.
- Restricted growth: According to the Infant Development, Environment, and Lifestyle Study, fetuses exposed to meth are 3.5 times more likely to be below the average size for their gestation age. Due to this, they’re more likely to have heart defects, physical deformities, and mental disabilities.
- Premature birth: Being born before 37 weeks in the womb exposes infants to problems associated with having underdeveloped lungs, hearts, brains, spinal cord, kidneys, etc. This can cause a wide range of complications that can easily lead to death in such small, vulnerable bodies.
- Psychological and intellectual disorders: People who endured meth exposure in the womb have a higher chance of developing mental illnesses, ranging from depression to schizophrenia; a low IQ; ADHD; and behavioral problems.
Many substances, including prescription medications, can be dangerous to a fetus. Any woman who becomes pregnant should always consult a doctor about any medications she is currently taking. Prescription medication abuse and addiction have increased substantially in recent years due to the increased numbers of prescriptions being given out and the relatively low cost of these drugs. People also tend to view prescription medications as being safer than illegal “street” drugs, but when abused, they can do as much damage to an adult or a fetus as meth or heroin.
Prescription medications come in many forms, including opioids similar to heroin, and stimulants similar to methamphetamine and cocaine. These types in particular can cause health issues like those listed above, including birth defects, developmental and functional issues, pregnancy complications, low birth weight, and premature birth.
In spite of efforts to help pregnant women get into treatment as soon as possible, addiction treatment centers are still woefully unequipped to deal with pregnancy. According to a SAMHSA study, only 17 percent of these facilities offered support groups or programs for pregnant or postpartum women.
If treatment is sought early, a pregnant mother struggling with addiction can prevent many of the damaging and potentially deadly effects that intoxicants can have on a developing fetus. Plenty of people with addiction disorders have given birth to perfectly healthy babies with no apparent deformities or health problems; however, proper care is needed to ensure the greatest chance of this happening.
Lack of education and extreme social stigma prevent many pregnant women from seeking treatment for addiction. They are often afraid of judgment as well as arrest and prosecution if they have already taken an intoxicant while pregnant, whether they knew they were pregnant or not. The difficulties and health issues associated with both substance abuse and pregnancy can also make it difficult to visit a doctor.
The result is that many people with addiction disorders who become pregnant end up attempting to quit on their own. This can be dangerous to both the mother and the fetus as the body attempts to adjust to the sudden change in chemistry. In rare cases, quitting cold turkey can kill a person, especially if the substance in question is alcohol, an opiate, or a benzodiazepine. Because the fetus is more sensitive, it’s even more at risk, and the stress that quitting puts on the body can trigger a miscarriage or even premature labor.
It’s never easy to deal with an addiction disorder. Pregnancy makes everything a lot more complicated, and it can be easy to panic when considering the choice between facing withdrawal and possibly hurting your child. No one ever has to do this alone. Most medical professionals, including primary care doctors, will be able to provide information on treatment options and give referrals to addiction treatment specialists. These specialists will be able to help you safely get through the detox process and keep you off any damaging substances for the duration of the pregnancy.