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  • Lisa Atkins

What Are the Issues with Substance Abuse While Being Pregnant?

Updated: Oct 13, 2022

By Deborah Scarborough

Pregnant woman seeing a doctor

Finding out your or your partner is pregnant can be both an exciting and scary time! We all want what is best for ourselves, our future baby and our partner or family member. It is exciting and hopeful to tell our parents they will be future grandparents or share with your best friend your good news! We immediately begin to research “what should I do now?” and how “can I have a healthy and happy pregnancy?” It can be very hard to know how to care for our bodies or encourage good care for our partners with so much advice out there on what to eat, drink, use for medications, exercise and much more when we have a baby on the way!

It can be scary to hear new information everyday on things that are “harmful” to our unborn babies. Just recently, Tylenol made the news as a possible medication of concern! With so much rapidly changing information, it is often hard to keep straight all the “dos” and “don’ts” of pregnancy for yourself, your partner, or your loved one. There is one topic that is sensitive, but certainly most important to pregnancy- Substance Abuse while Pregnant.

Substance Abuse is a common issue and no one, especially a new mom or family member of a new mom, should be ashamed to seek help if you feel substance abuse may be a problem during pregnancy.

Substance Abuse issues while pregnant can look like: drinking too much alcohol, some studies say ever, during pregnancy. Or, ingesting marijuana or THC containing products, even occasionally, while pregnant, or using recreational or “street drugs,” at all during our pregnancy. Experts do agree, any use of alcohol, marijuana, and other recreational drugs can be harmful to our bodies and unborn babies. Doctors and OBGYN’s all ask pregnant moms to stop substance use and encourage our partners or loved ones to stop all substance use while pregnant.

How do I know if me or my loved one have issues with Substance Abuse while being Pregnant? Substance Abuse is usually defined as using a substance, like alcohol, Marijuana/THC, or any “street drugs”:

1) Often during a week or month

OR 2) When you use, you ingest in excess of what you planned or what you are prescribed


3) An inability to stop drinking or using when you say you will stop completely

If you are having trouble stopping any substance use, for your body and your baby, seeking help is the best solution. Do not be afraid to be honest with your doctor and get the help you need.

What Substance Use is Most Harmful while being Pregnant?

Alcohol has long been known to cause issues for a mother and her developing baby. If you are expecting, or your partner is expecting, and she is drinking, it is advised you/she cut back or stop completely. If you have a loved one who continues to drink while pregnant, education about the effects of alcohol and issues with substance use while pregnant can help. Alcohol use during pregnancy is highly linked to miscarriage and stillbirth. If your baby does survive, alcohol use is associated with a spectrum of physical and mental health issues for your baby which can include low birth weight, cognitive problems such as ADHD, physical issues such as asthma, and even fetal alcohol syndrome which is a combination of physical defects and cognitive impairments that can range from mild to severe.

Marijuana, and other THC containing products (i.e. Gummies, Delta 8, Delta 10, “vape pens,”) all carry the active ingredient THC into your body and into your baby. With the popularity and availability of THC containing products, even many that are legal at your local “vape shop,” it can seem like “no big deal” to use THC occasionally. That is understandable in our current culture but we want to help educate you and your partner to be able to avoid substance use issues while pregnant for your new baby’s health with no judgements.

If you have a loved one ingesting THC in any way, it can be hard to know exactly how to talk to them about substance use issues while pregnant. Many moms to be and their families are not educated about the effects of THC on their expected baby. Use of THC interrupts yours and baby’s bodily ability to uptake folic acid, an important nutrient for brain and spine development, and for you to keep healthy bones during pregnancy. Even occasional use of THC during you or your partner’s pregnancy can influence your baby’s entire 10 month (37-40 week) development inside mom. This is because the THC is stored in the baby’s fat and placenta far longer than in you or your partner’s body. That means, your baby’s intake of vitamins like folic acid, is diminished even with occasional use of THC. In other words, mom thinks, “I haven’t smoked (vaped, eaten a gummy) in 3 months” but all that time after use, your baby’s uptake of vitamins and minerals is being diminished due to the release of stored THC. If your baby cannot uptake enough folic acid, they could develop neural tube defects, such as spina bifida (a hole in the spine) which can range from mild to severe impacts, and /or have low birth weight which carries many risks as your baby grows after their birth. If your or your partner’s body cannot get enough folic acid, miscarriage and still birth can also occur.

Use of recreational or “street drugs,” even occasionally, or overtaking our prescribed medications, such as benzodiazepines for anxiety, can cause health problems for a developing baby. Recreational drugs, sometimes called “street drugs,” often include cocaine, ecstasy and heroin or prescription pain pills not prescribed to us. There is still much shame and stigma around admitting use of these drugs to your OBGYN, but there should not be. You will also not face legal trouble or Child Protective Services involvement for admitting occasional substance use and asking for help. In fact, your OBGYN will have education, resources, and places you can seek professional help that are confidential. Doctors and researchers all advise seeking immediate help to stop any use of all recreational drugs during pregnancy. Continued use of recreational or “street drugs” can lead to miscarriage and still birth. If your baby does survive, low birth weight, premature birth, and heart defects are most common, along with birth defects that include facial and finger/toe/limb deformities. Cognitive and brain development problems are also possible too, including learning and behavior problems. Possibly most devastating is also the increased risk of Sudden Infant Death Syndrome (SIDS, where a baby dies in their sleep, called ‘crib death’ in earlier years) in babies whose moms engaged in use of recreational or “street drugs.”

Of special importance is any overuse of pain pills, recreational use of pain pills not prescribed to you, and illegal drugs, including the use of heroin (all of these substances are also called opioids). Even when used occasionally during pregnancy, the issues while pregnant caused by opioids are harmful. Use of any kind of opioids while pregnant is very serious, and you should seek help from your physician, or urge your partner to seek help to stop. There are safe medications available for women who are pregnant to ease the cravings and withdrawal symptoms associated with opioids.

You should discuss any opioids you are using with your doctor before you quit. Stopping opioids is the best thing to do for yourself and your pregnancy but you or your loved one will need medical treatment. Going “cold turkey” or “detoxing at home” can lead to your unborn baby feeling the same withdrawal you do- but inside your body where they cannot get help! Mothers, their partners and family members should know a pregnant woman going “cold turkey” carries serious risk to herself and the pregnancy. As a mom, you may miscarry, have your baby too early, or your baby may be stillborn. A mom and unborn baby risk death if pain pills or heroin are stopped “cold turkey.”

I think I have substance abuse issues while Pregnant- What do I Do?

We at a Helping Hand of Wilmington and your OBGYN want you to be open and honest with any substance use you engage in to avoid substance abuse issues while pregnant. There is no shame in admitting you are confused about what to stop or how to limit your intake of substances. It is understandable in our culture that many moms and families say things like, “Well I drank when I was pregnant with you- I smoked too- look you are fine!” Or, “Look at European countries, they drink while pregnant!” But it is now widely known any anecdotal evidence of substance use while pregnant “turning out fine,” is not always and not usually the case.

We encourage you to talk to your OBGYN and book an appointment for substance abuse counseling today. Counseling can help you navigate your substance abuse issues, in a safe and secure environment, while your OBGYN looks after your medical health and your baby.

What will my counselor do about Substance Abuse issues while pregnant?

Your counselor will listen to you openly, non-judgmentally, and without penalty. Sometimes, just being able to list all your stressors and admit to someone, “I just want a drink!” can help you unpack why you are engaging in substance use at all while pregnant. If your issue is the use of THC or “street drugs,” your counselor can provide you with the education and tools to abstain, along with understanding things like, “I know I should stop smoking marijuana, but it’s always around, my partner smokes,” or “I can avoid the cocaine but I need help to stop using pain pills.” We have heard many journeys with substance use issues and are open to helping you avoid any type of substance abuse issue while pregnant with consideration, care and skill.

Reaching out for help with substance use issues while pregnant is covered by insurances, Medicaid, and there are some free grants and programs as well for those who lack insurance. If you have been awarded Medicaid just for your pregnancy, sometimes called “pregnancy Medicaid” your substance abuse care can be covered when you talk to your OBGYN. Do not hesitate to ask for help for fear you cannot afford it.

At A Helping Hand of Wilmington, we have experienced group and individual counselors who can help you and your growing baby. We can coordinate care with your medical provider. Please reach out today to start your pregnancy off healthy and happy!

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