Substance abuse has the potential to cause many risks in the pregnancy. The use of illicit drugs or alcohol can lead to health problems for both the mother and the fetus. Unfortunately, more than 4.4% of pregnant women in the U.S. abuse one or more substances during pregnancy. The exact numbers are unknown because many women may fear reprisal. It’s safe to assume that a much larger percentage of the population does abuses drugs or alcohol during the pregnancy. The types of substances abused by each woman will vary. Some women may abuse stimulants, like cocaine, or depressants, like alcohol. Others may abuse prescription drugs, like opioids and benzodiazepines. Some others may abuse illicit drugs like heroin or methamphetamine. Many women will abuse more than one substance at a time. Those who do abuse any type of substance should seek medical help as soon as possible. Those who continue the substance abuse may put not only themselves, but also their pregnancy at risk. It’s possible to miscarriage from drug use. It’s also possible for the fetus to develop permanent and serious health problem. This article will take a look at 9 substances that carry risks during pregnancy. Those who are addicted to these substances or use it recreationally should highly consider seeking help immediately.
There are over 750,000 pregnancies each year exposed to cocaine. These numbers may actually be higher, as many women may be hesitant to report cocaine use during pregnancy. After all, they are afraid of the consequence and repercussions that may follow. Many pregnant women are also afraid to get help, even if they had a cocaine addiction prior to getting pregnant. Cocaine use during pregnancy can exacerbate certain symptoms in the pregnant mother. Pregnant women are more likely to experience maternal migraines and seizures. They are also more susceptible to separation of the placental lining from the uterus and premature membrane rupture. This can lead to a dangerous delivery. Cocaine is a stimulant and will also magnify otherwise normal cardiovascular changes. Many pregnant mothers will experience high blood pressure, spontaneous miscarries, a difficult delivery and pre-term labor. They may spend a longer time at the hospital during labor and may need more help than other mothers who did not engage in any type of substance abuse.
The Effects to the Baby
Studies show that babies born to mothers who were abusing cocaine often have lower birth weights. They also tend to have smaller head circumferences and are shorter in length. Cocaine use during fetal development can also lead to some subtle deficits in some children. Some babies will develop behavior problems. They may have difficulties with self-control. These children may also have a lower cognitive performance. They may have difficulties concentrating and staying focused. These babies are more likely to experience memory problems or difficulties learning a language. Some of these effects may persist even after development. Brain scans show that these children also have different activity levels than babies who were born to healthy mothers. Unfortunately, there’s not enough research in this field. No one knows exactly what types of long-term damages are caused by cocaine use during the pregnancy.
Methamphetamine is another common substance abused during pregnancy. Studies show that approximately 19,000 pregnant women indulge in meth abuse. Meth contains highly toxic chemicals that can damage one’s DNA and do a lot of harm on the body. It’s definitely one of the riskier drugs to try when pregnant. This substance affects mothers in dangerous ways. In general, women who abuse this illicit drug will have low body mass index measurements. Pregnancy is a huge strain on the body. The low body mass can lead to a riskier pregnancy and more complications. Pregnant women who abuse meth will generally have longer hospital stays. Pregnant mothers may also be at a higher risk of pre-term labor and delivery. Studies show that 29% of mothers will need a C-section. Some other issues that may affect the mother include:
- Placenta abruption. This phenomenon affects about 10% of pregnant women who use meth. The abruption can lead to hemorrhaging, which can also lead to death.
- Eclampsia and high blood pressure. This is mostly due to the uncontrolled high blood pressure. Eclampsia can affect the liver, brain and kidneys. The high blood pressure can lead to strokes, heart problems and kidney damage.
Meth abuse and pregnancy both place a huge strain on the mother’s body. It can lead to permanent and irreversible damage and harm.
The Rise of “Meth Babies”
There’s been an increase in “meth babies”. This toxic and deadly substance can have just as much effect on the well being of the fetus. Exposing fetuses to meth can lead to:
- DNA damage
- Heart defects
- Mental and physical abnormalities
Most babies carried by women who are using meth will be delivered prematurely. This means that there’s a chance that they will have underdeveloped brains, hearts and kidneys. Naturally, mortality rates are also quite a bit higher. These babies are also at risk of dying from fetal stroke, premature births and miscarriages. This phenomenon is studied so well that there’s even a scientific name for it, Prenatal Methamphetamine Exposure. Mentally, these babies are also going to be in for one hell of a ride. They’re likely to experience mental health problems, emotional problems and behavioral problems. For example, many meth babies will experience sleep problems. As they grow up, they’ll also have reduced fine motor skills and poor coordination.
#3. Prescription Opioids
Pregnancy can come with a lot of aches and pains. Many pregnant mothers may turn to prescription opioids. They may also need these prescription medications for other reasons as well. In 2007, 22.8% of women enrolled in Medicaid programs took prescription opioids while pregnant. From 2000 to 2009, there was a fivefold increase in maternal opioid use. Quite a few opioids are abused during pregnancy. Some popular options include oxycodone, methadone, codeine and hydrocodone. These painkillers differ in intensity. Maternal opioid use is dangerous for both the mother and the fetus. Fluctuating opioid levels in the mother may cause the baby to experience withdrawal symptoms. This can do irreparable damage to the placenta function. The babies are at risk of neonatal abstinence syndrome. They’re also more likely to have a stunted growth or experience preterm labor. Fetal convulsions and fetal death are among some of the other direct physical risks that may be experienced. There are some indirect risks to the fetus as well. The fetus may struggle with malnutrition and poor prenatal care. They may also have an increased risk for maternal infections, like HCV and HIV.
Understanding the Basics of Neonatal Abstinence Syndrome
Babies who are born to mothers that abuse opioids are more likely to struggle with neonatal abstinence syndrome (NAS). This happens when the fetus or baby develops a physical dependence to the prescription opioids. When there are no more opioids in their system, the infant will experience withdrawal symptoms. Symptoms include diarrhea, fever, irritability, seizures and difficulty feeding. The withdrawals can begin to kick in about 8 to 12 hours after birth. It often happens much sooner. The withdrawals can continue to persist for weeks. Depending on the severity of NAS, the babies may need to go through medical detox. Between 2000 to 2012, hospitals have seen a fivefold increase in NAS. These rates continue to rise year after year. These numbers show that this issue is a growing concern.
Since heroin is basically the illegal version of opioids, it has similar effects on the baby and the mother as above. The most concerning issue is NAS. Babies are also susceptible to birth defects, poor intrauterine growth, premature birth and seizures. The primary difference with heroin is that it can cause long-lasting withdrawal symptoms. Withdrawal symptoms can last up to 6 months in babies. Most of these babies will need intense medical care and hospitalization. It’s important to note that there’s no set standard for heroin. It can be mixed with other illicit substances and toxins. As a result, it’s possible for pregnant mothers and fetuses to experience other side effects as well. Pregnant women who abuse heroin have a high-risk pregnancy. They need more prenatal care. They’re susceptible for developing mental health disorders as well. When a mental health disorder and a substance use disorder appears at the same time, it’s known as a co-occurring disorder. Pregnant women are also more susceptible to antepartum hemorrhaging. They may also experience pre-eclampsia and respiratory failure.
Using Buprenorphine to Treat a Heroin Addiction
It’s important to wean pregnant women off of heroin as soon as possible. Most addiction recovery centers highly recommend medical detox. There are quite a few treatment options to choose from; however, the best option available is probably buprenorphine. Buprenorphine is a partial opioid agonist. While it acts on the same opioid receptors in the central nervous system (CNS), it is not as addictive as methadone. This is because it has a “ceiling effect”. After a certain threshold, no additional effects will be experienced. It doesn’t matter how much more of the drug is taken.
#5. Benzos/ Anti-Anxiety
Benzodiazepines and anti-anxiety medications are often taken during pregnancy. These medications may help the mother deal with anxiety and panic attacks; however, it could be harmful to the baby. Common benzodiazepines taken by pregnant women include Ativan, Valium and Klonopin. Studies show fetuses that are exposed to benzodiazepines have an increased risk of cleft lip and palate. The risk is higher for fetuses that were exposed during the first trimester. Although this can happen, statistically, the chances are quite low, sitting at about 0.7%. Symptoms of toxicity have also been reported in newborns. Thee symptoms include decreased muscle tone, respiratory problems and sedation. Depending on the dosage of the medication taken, babies may also exhibit withdrawal symptoms. Common benzodiazepine withdrawal symptoms include irritability, sleep disruptions, exhaustion, loss of appetite and seizures. If taken as prescribed, the mothers will usually experience minimal side effects. While some women may be abusing benzodiazepines, others may be unable to stop their anti-anxiety medications. They may need to remain on benzodiazepines throughout their pregnancy. This may be their doctor’s recommendation. In these situations, an obstetrician must be consulted.
Scientists and doctors have long known about the risks of drinking while pregnant. There is no safe amount of alcohol use during pregnancy. All types of alcoholic beverages are equally as harmful. It doesn’t matter whether the pregnant mothers want to drink a wine, a beer or a shot of hard liquor. The reason why alcohol is so dangerous is because it will enter the bloodstream and travel to the fetus. Studies show that 1 in 10 women will drink alcohol when they are pregnant. One-third of the women, who do drink, claim that they binge drink.. Others may take a sip here and there. Pregnant women who drink alcohol will have a high-risk pregnancy. There are more prone to miscarriages and other health problems. With that said, the brunt of the damage is placed on the fetus. The fetus becomes susceptible to developing fetal alcohol spectrum disorders (FASDs).
Characteristics and Behaviors of Fetal Alcohol Spectrum Disorders (FASDs)
Fetal Alcohol Spectrum Disorders (FASDs) actually refer to a whole host of side effects that can happen to the fetus. The conditions and symptoms that appear in each baby will differ. It will depend on the length of the alcohol abuse and the dosage taken. Other factors will also come into play. A person with FASD may have the following characteristics and behaviors:
- Abnormal facial features
- Difficulties with paying attention
- Heart and/or kidney problems
- Hyperactive behavior
- Learning disabilities
- Low body weight
- Low IQ
- Poor coordination
- Poor memory
- Small head size
- Speech and language delays
- Stunted growth
- Vision or hearing problems
There are many other characteristics and behaviors associated with FASDs. These babies need additional medical care and attention throughout their entire life.
Types of FASDs
There are different types of FASDs. They are characterized by unique symptoms. Understanding the type of FASD that a baby has is crucial in getting him or her the right type of treatment. The different types of FASDs include:
- Fetal Alcohol Syndrome (FAS). This is the most intense FASD. In worst-case scenarios, it can lead to fetal death. Those with FAS may have abnormal facial features and central nervous system (CNS) problems. They may also have learning problems, poor memory and short attention spans. They often have a difficult time getting along with others.
- Alcohol-Related Neurodevelopmental Disorder (ARND). People with ARND have intellectual disability and behavior problems. They also often have poor impulse control and judgment.
- Alcohol-Related Birth Defects (ARBD). People with ARBD may have developmental issues. They may have either heart, kidney or bone problems.
- Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE). Children with ND-PAe will have behavioral problems and cognitive and memory problems. They are more prone to tantrums and mood issues. They may also have difficulties with day-to-day living.
Babies who were exposed to alcohol as a fetus will develop more health issues than normal babies. They may need support and assistance throughout their entire lives.
Battling with depression can be difficult when pregnant. Researches used to believe that pregnancy protected against depression. However, we now know that’s not true. Between 1998 and 2005, one in every 20 women took antidepressants before conceiving or during the pregnancy. Deciding whether to continue or to stop using antidepressants can be difficult. While the medications may pose some risk to the baby, depression is just as harmful. It’s important not to make any decisions before speaking with a doctor. Don’t hesitate to talk to an ob-gyn and a psychiatrist. Weigh out the pros and cons before deciding what to do next. Not all antidepressants are safe for pregnancy. With that said, selective serotonin reuptake inhibitors (SSRIs) and older medications are generally the best option available. They’re considered to be quite safe although there is a low risk for birth defects. With all that said, it’s vital that pregnant women only take the antidepressants as prescribed. Addiction can also lead to a high-risk pregnancy.
#8. Pain Medications
If you need pain medications while pregnant, consider taking acetaminophen. This is the active ingredient in Tylenol. When used as prescribed, this drug is fairly safe. They can help alleviate some pain, like with headaches or muscle pain. Pregnant women should also try a cold compress and rest. Doctors recommend that pregnant women stay away from the following pain medications:
- Ibuprofen, the active ingredient in Advil and Motrin
- Naproxen, the active ingredient in Aleve
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
Studies show that taking these medications near conception or during early pregnancy can increase one’s risk of miscarriage and birth defects. Although pain medications are not as dangerous as other substances, it’s still best to avoid them as much as possible.
#9. Over-the-Counter Medications
So, what about over-the-counter cough and cold medicines and allergy medicines? Many believe that these medications don’t need a prescription, so they must be safe. The truth is that some of these medications are fine, but others aren’t. Before taking any medication whatsoever, speak to a doctor first. Needless to say, the safest way to deal with a cold or an allergy is through non-drug remedies. This may include drinking lots of fluids and getting lots of rest. A cold won’t pose any special risks to the pregnancy, but a flu will. Thankfully, flu shots are safe to get during pregnancy. Most doctors recommend that pregnant women get a flu shot during flu season. This is especially true for those who are in their second or third semester. As far as allergy medicine goes, many doctors believe that antihistamine chlorpheniramine is safe. Pregnant women can take these medications without having to worry about a thing. Unfortunately, not a lot of research has gone into newer drugs like loratadine, so it’s best to avoid them. To deal with a cough or a cold, most doctors recommend a suppressant like dextromethorphan. As long as it is taken as prescribed, it is completely safe. The only thing that pregnant women should avoid is iodine. Iodine can, at times, be found in cough products. They can cause potentially life-threatening thyroid problems in the fetus. Nasal sprays that contain oxymetazoline are also considered to be relatively safe. They’re non-addictive, so it’s difficult for pregnant women to abuse them.
Understand the Risks of Taking Drugs or Medications When Pregnant
Pregnant women who engage in substance abuse during the pregnancy need a lot of medical assistance. They should consider seeking gender-specific addiction treatment services. The addiction treatment should also include prenatal and parenting skills training. Mental health counseling and employment assistance will also come in handy. A specialized drug rehab facility can often offer all of the services needed. They’ll help pregnant women prepare to become parents. Behavioral therapy is just as important for pregnant women than any other drug abusers and alcoholics. Motivational interviewing, motivational incentives and contingency management are particularly promising among pregnant women. Current research shows that women tend to respond best to these types of therapies. They’ll also need individual counseling and family therapy, especially if their relationship with their family or spouse has become strained. If you or a pregnant woman you know is addicted to drugs, it’s important to get help as soon as possible. Even if you’re not an addict and just a recreational user, you may still need help. Those who seek help as soon as possible may be able to reduce the severity and type of damages inflicted upon the baby. They may be able to turn their situation around and have a safe pregnancy. Here, at Denver Women’s Recovery, we have the recovery tools needed to help you get clean. We can help you make informed choices that are better for your health. Our addiction specialists are here to help both you and your baby. If you’re wondering whether you’ll like our facility, feel free to take a virtual tour. You can also schedule an appointment with us if you’d like, and we’ll walk you through the facility.