Addiction and Pregnancy

What is Addiction?

Addiction is a chronic dysfunction of the brain system involving motivation, memory, and reward. Essentially, addiction occurs when the brain decides that it needs something so badly that it isn’t able to function correctly without it.

Addiction can involve substance abuse, such as drugs or alcohol, but it can also take the form of behavioral addictions like shopping, gambling, food, or even exercise.

A person suffering from addiction can experience the following:

• Inability to stop using a substance or engaging in an activity
• Increased desire for the substance or activity
• A lack of understanding of how their addiction might be causing problems both for themselves and others around them

Individuals dealing with an addiction will continue to pursue their addiction regardless of the negative impact on their lives.

Substance Abuse Trends in Pregnant Women

Unfortunately, many pregnant women struggle with substance use disorders and may be afraid to seek alcohol or drug treatment services. The stigma of addiction can be daunting, but expectant mothers may be even more fearful of judgment and therefore avoid asking for help.

The good news is that substance abuse treatment is also available for pregnant mothers or women with newborns. Healthcare providers in the addiction treatment field don’t discriminate, so any fear about outside perceptions shouldn’t keep you from doing what’s best for you and your child.

The prevalence of alcohol and drug abuse during pregnancy is concerning. According to a 2020 survey conducted by the Centers for Disease Control and Prevention (CDC), 10% of women reported actively drinking alcohol while pregnant. An alarming 40% of pregnant women surveyed admitted to using one or more other substances.

Here are some additional facts about substance abuse trends among pregnant women:

• The Substance Abuse and Mental Health Services Administration (SAMHSA) found that roughly 5% of pregnant women ages 18 to 44 drank alcohol during their first trimester.
• SAMHSA also reports that nearly 5% of pregnant women drank during their second trimester; roughly 2.5% drank during their third trimester.
• Women who abuse stimulants or prescription painkillers are 2.2 times more likely to have a stillbirth.
• Children born to mothers who drank and smoked past their first trimester are 12 times more likely to die of Sudden Infant Death Syndrome (SIDS).
• Roughly 5% of all pregnant women actively use one or more addictive substances.
• Tobacco use increases the chances of stillbirth by anywhere from 1.8 to 2.8 times.

How Drugs and Alcohol Impact Pregnancy

Pregnancy takes an enormous toll on a woman’s body. From hormones to water retention, pregnancy can be an exhausting experience.

Some women experience more severe health issues during pregnancy, including gingivitis, high blood pressure, anemia, depression, etc. Substance abuse increases the risk to her health, as her body is already significantly taxed during pregnancy.

Besides impacting her own physical health, anything that goes into a pregnant woman’s body will have an impact on her fetus, both good and bad.

Various substances of abuse, including drugs, alcohol, and even nicotine, can harm both the mother and the unborn baby when these substances pass through the placenta. Babies born to mothers who actively used drugs during their pregnancy, for example, will typically be born with a drug dependency themselves.

Drug and Alcohol’s Effects on a Fetus

A significant reason why there is such an extensive list of things women can’t eat or drink when pregnant is because the fetus absorbs everything the woman consumes—including drugs and alcohol.

When the woman eats, so does the fetus. If the woman smokes, so does the fetus. If the woman ingests alcohol or drugs, you guessed it: so does the fetus.

Alcohol’s Effects On a Fetus

While some studies have suggested that women can consume a small amount of alcohol during pregnancy, the CDC officially advises pregnant women to avoid ANY alcoholic beverages.

If a woman drinks during pregnancy, the fetus can experience fetal alcohol syndrome (FAS) and/or fetal alcohol spectrum disorders (FASD). Both FAS and FASD are disorders caused by a woman drinking during pregnancy. The more a pregnant woman drinks, the higher the risk of either or both developing.

Fetal alcohol syndrome can lead to problems with the central nervous system, abnormal facial features, and growth deficiency. Children born with FAS may also suffer from learning disabilities and physical disabilities such as vision or hearing problems.

The Effects of Drug Use on a Fetus

Drug use during pregnancy can have an adverse reaction on the mother, and it can also negatively impact the child. It is possible for women who abuse drugs during pregnancy to give birth to “drug babies.”

“Drug babies” can suffer from a variety of developmental problems. In addition, they are more susceptible to the adverse side effects associated with the drug(s) and the withdrawal symptoms.

Drug use during pregnancy can lead to an increased risk of brain damage, strokes, seizures, and respiratory failure. Drugs can even impact birth outcomes, increasing the chance of stillbirth.

Drug and Alcohol’s Effects on Pregnant Women

Drinking and doing drugs while pregnant has adverse effects on the fetus and can significantly negatively impact the expectant mother.

The American College of Obstetricians and Gynecologists (ACOG) reports that about 14 to 23% of pregnant women experience depression before childbirth. The use of alcohol and several different drugs can cause or significantly increase the effects of depression, putting the mother (and her child) at risk.

Alcohol’s Effects on a Pregnant Woman

Drinking while pregnant can increase the risk of a miscarriage, which, in turn, can be very dangerous for the woman. A miscarriage can lead to excessive bleeding, infection, depression, and other medical issues.

Even if the mother doesn’t have a miscarriage, drinking while pregnant can increase the chances of premature birth or even a stillbirth.

The Effects of Drug Use on Pregnant Women

If a woman uses and abuses illegal drugs during pregnancy, she puts herself at risk beyond what could happen to the fetus.

Taking any drugs that a doctor does not prescribe during pregnancy can lead to health problems such as blood and heart infections, skin infections, infectious diseases, anemia, and hepatitis for the mother. It can also lead to a miscarriage, premature birth, premature detachment of the placenta, or stillbirth.

Drug Use and Alcohol’s Effects on Fertility

Abusing drugs and alcohol can significantly impact fertility for both men and women.

Some specific fertility issues that can arise from drug or alcohol use include:

• Marijuana impacts a woman’s hormones, directly affecting her ovulation cycles; it can also decrease a man’s sperm count.
• Alcohol can affect a woman’s hormones and can disrupt conception during ovulation. Alcohol also lowers a man’s testosterone levels.
• Methamphetamine can lower a man’s sperm count and affect the mobility of existing sperm, making it more difficult to fertilize a viable egg.
• Opioid use reduces the possibility of pregnancy by 29%
• Cocaine, heroin, and ecstasy can cause permanent damage to both male and female reproductive systems. Cocaine and heroin can also lower a man’s sperm count and testosterone levels.

Addiction Complications After Pregnancy

Drinking alcohol or using illicit drugs while pregnant can lead to major post-pregnancy issues. In addition to the various deformities or medical conditions the child can be born with, stillbirth is an additional risk.

In addition, alcohol and drugs quickly pass through breastmilk, meaning if the mother drinks and breastfeeds, she can pass those substances along to the nursing baby.

Postpartum Depression

It’s not uncommon for women who don’t drink or do drugs while pregnant to experience postpartum depression after giving birth. Between their hormones being all over the place and their lack of sleep, it’s understandable why new moms might experience behavioral health challenges.

Women who suffer from substance abuse are significantly more likely to experience postpartum depression. Anywhere between 20% and 40% of women with a history of substance abuse will experience postpartum depression during the first three months after childbirth.

Congenital Disabilities (Previously known as Birth Defects)

New and expecting mothers are often concerned about the overall health of their babies. Drinking and doing drugs while pregnant can significantly increase the child’s risk of being born with a congenital disability (previously known as “birth defects”).

Some congenital disabilities associated with substance abuse include:

• Facial abnormalities
• Vision problems
• Heart problems
• Hearing problems
• Poor coordination
• Below average height and/or weight
• A small head
• Deformed limbs
• Behavioral problems
• Mental health issues
• Delayed development
• Impaired motor skills
• Kidney defects

Premature Birth

According to the National Library of Medicine, preterm birth (PTB), or premature birth, is defined as birth before the 37-week mark of pregnancy.

While women who don’t use and abuse drugs and alcohol are still at risk of a PTB, the numbers are significantly higher for those who suffer from a substance abuse issue or addiction.

One specific example of this comes from a study done by the NIH. This study shows that while only 6.7% of women who do not drink or do drugs during pregnancy will have a PTB, that number shoots up to over 24% amongst women who use cocaine.

Stillbirth

A stillbirth occurs when the baby dies either before or during delivery. If the baby dies before delivery, it has to happen after the 20-week mark to be considered a stillbirth and not a miscarriage.

Stillbirths are relatively uncommon amongst women who do not consume alcohol or abuse drugs during pregnancy, affecting roughly 1 in every 160 births.

The chances of stillbirth increase if the mother drinks, smokes, or uses other illicit substances during pregnancy. According to the National Institute on Drug Abuse, the chances of stillbirth increase to 1.8 to 2.8 times as likely for pregnant women who smoke or use drugs.

Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome, also known as NAS, is a group of medical conditions that occur when a fetus is exposed to certain drugs while in the womb.

A baby suffering from neonatal abstinence syndrome will often show signs of withdrawal after birth since it is no longer getting the substance or substances that it became dependent on while in the womb.

Opioid dependence is the most common cause of NAS, but other drugs that may lead to NAS include antidepressants, benzodiazepines, barbiturates, and alcohol.

Fetal Alcohol Syndrome

Drinking alcohol during pregnancy, especially heavily, can cause the baby to be born with various defects and medical conditions. One of those medical conditions is fetal alcohol syndrome (FAS).

FAS can lead to a variety of mental and physical issues, including:

• Facial deformities
• Learning disabilities
• Vision and hearing problems
• Growth deficiency
• Central nervous system problems

Fetal Alcohol Spectrum Disorders

Alcohol exposure as a fetus can also cause fetal alcohol spectrum disorders (FASDs). Children who suffer from FASDs may have permanent and untreatable problems.

Fetal alcohol spectrum disorders often affect how the baby’s brain functions and can result in them having trouble learning, communicating, or taking care of themselves. It can also result in intellectual and developmental disabilities.

Sudden Infant Death Syndrome (SIDS)

Sudden infant death syndrome (SIDS) occurs when a baby unexplainably dies. It usually happens while the baby is sleeping, and what makes it particularly devastating is there are usually no warning signs.

SIDS can often result from brain defects, low birth weight, or a respiratory infection—all potential side-effects of women drinking or abusing drugs during pregnancy.

Getting Help for Addiction While Pregnant

It’s never too late to get help for yourself and your unborn child; the sooner you seek treatment, the better.

No matter what substance you are struggling with, treatment facilities are available to help you—including facilities that specifically cater to women’s health and prenatal care.

Challenges to Seeking Help while Pregnant

As an expectant mother, you might feel as though you are being judged for anything that you do while pregnant. The fear and stigma associated with a pregnant woman suffering from a substance abuse issue can make it feel too intimidating to seek help.

However, It’s important to remember that no matter what others might think, your child’s health, safety, and well-being are all that truly matter.

Types of Addiction Treatment for Pregnant Women

Anyone who is seeking addiction treatment has a unique set of needs. However, a pregnant woman will have even more special needs due to her pregnancy.

Unlike others in need of treatment, a pregnant woman not only needs help for herself but for her unborn child as well. Therefore, it is crucial to seek a treatment facility that has experience treating pregnant women.

Inpatient Treatment

For pregnant women, inpatient treatment can be crucial for both the health of the mother and the baby. With inpatient treatment, pregnant women have access to 24/7 medical care that they won’t have with outpatient treatment.

Additionally, some inpatient treatment centers offer help and support for both the mother and her child even after the baby is born.

Outpatient Treatment

For mothers-to-be that aren’t able to enter into an inpatient treatment program, there are also outpatient programs specifically designed for pregnant women.

Outpatient treatment allows the pregnant mother to attend meetings and therapy sessions during the day while continuing to attend to her other commitments.

Some facilities even offer childcare for those in need during outpatient treatment.

Counseling and Mental Health Support

Being pregnant and suffering from substance abuse or addiction can take a toll on a woman’s mental health. That’s why mental healthcare and support services are vital to a pregnant woman’s overall treatment.

Most treatment facilities also offer mental health and support services such as group therapy, peer support groups, behavioral therapies, and transitional programs. These behavioral health programs will also tackle issues related to the addiction itself and help recovering addicts create better habits and develop positive coping mechanisms.

Medication-Assisted Treatment

Medication-Assisted Treatment (MAT) is often used during and after addiction treatment. During MAT, individuals receive specific prescription drugs designed to decrease withdrawal symptoms and help them avoid relapse by reducing or eliminating cravings.

The US Food and Drug Administration (FDA) has approved the use of methadone and buprenorphine for MAT during pregnancy.

Benefits of Seeking Treatment Before Birth

The likelihood of a child being born with an issue is higher in women who suffer from substance abuse or addiction. However, seeking treatment before the child is born can help improve not only the quality of life of the mother but the child as well.

Entering into treatment before the child is born gives the mother-to-be access to medical care and treatment that can help her and her baby and give her the best chance of birthing the healthiest child possible.

Looking for Addiction Treatment While Pregnant?

Ideally, pregnant women should stop drinking and using unapproved drugs immediately upon finding out they are pregnant. In a perfect world, they would also stop using these illicit substances before even getting pregnant.

We don’t live in a perfect world, though. Some women continue to use and abuse drugs and alcohol well into their pregnancy. There are resources for those women to get the help needed for addiction during pregnancy.

Call the SAMHSA helpline at 1-800-662-4357 to receive a referral to a local treatment program or visit their online program locator to find addiction treatment options in your area.