Drug Use During Pregnancy: Risks, Effects & How to Get Help

What Counts as Drugs During Pregnancy?

Drugs (also called narcotics or illicit substances) are substances that produce intoxication, are harmful to use, and can cause dependence. This includes illegal drugs like cocaine, heroin, and methamphetamine, as well as prescription medications used improperly. Even cannabis, which is legal in some places, poses risks during pregnancy.

When we talk about drugs during pregnancy, we refer to any substance that produces a "high" but is harmful and can lead to addiction. The medical term is substance use disorder. These include both illegal drugs and prescription medications that are misused or taken without proper medical supervision.

Drugs are also referred to as narcotics. A substance is classified as a narcotic based on its potential to cause dependence, its effects on the brain, and its potential for misuse. New drugs are constantly being developed and sold, particularly online. These novel substances can be especially dangerous because their effects during pregnancy are often unknown.

It's important to understand that even substances that may seem "natural" or "harmless," such as cannabis, can have significant effects on fetal development. The developing brain is particularly vulnerable to all psychoactive substances, regardless of their legal status or social acceptance.

Prescription Medications That Require Caution

Some prescription medications are also classified as controlled substances due to their potential for dependence. These include opioid pain medications (such as morphine, oxycodone, and codeine) and benzodiazepines (such as diazepam, alprazolam, and lorazepam). When used incorrectly, these medications can harm your developing baby.

Using a medication incorrectly during pregnancy can include taking it more frequently than prescribed, taking higher doses than prescribed, using someone else's prescription, or obtaining medications without a prescription. If you are pregnant and taking any controlled medication, it is essential to inform your healthcare provider so they can adjust the dosage or find a safer alternative.

Common Types of Drugs and Their Classification

Understanding the different categories of drugs can help you recognize substances that may be harmful during pregnancy. Each category affects the body differently, but all pose risks to fetal development.

How Do Drugs Harm the Pregnancy?

Drug use during pregnancy increases the risk of serious complications including miscarriage, bleeding, placental abruption (when the placenta separates from the uterus), premature labor, stillbirth, and maternal death. The risk depends on the type of drug, frequency of use, and timing during pregnancy.

When you use drugs while pregnant, the substances you consume can cause direct harm to your pregnancy, separate from their effects on your developing baby. Understanding these risks can help motivate change and highlight the importance of seeking help as soon as possible.

The placenta, which provides oxygen and nutrients to your baby, is particularly vulnerable to the effects of drugs. Stimulants like cocaine and methamphetamine cause blood vessel constriction, which reduces blood flow to the placenta. This can lead to placental insufficiency, where the placenta cannot adequately support your baby's growth and development.

Drug use also affects the uterine environment in ways that can trigger premature labor. The stress that drugs place on your body, combined with the direct effects on uterine blood vessels and muscles, significantly increases the chance that your baby will be born too early. Premature babies face numerous health challenges and may require extended hospitalization after birth.

Specific Pregnancy Complications

The following complications occur more frequently in pregnancies affected by drug use. While not every drug-exposed pregnancy will experience these problems, the risks are substantially higher:

• Vaginal bleeding: Drug use can cause abnormal bleeding at any stage of pregnancy, which may indicate placental problems or threaten miscarriage
• Placental abruption: The placenta separates from the uterine wall before delivery, cutting off oxygen and nutrients to the baby. This is a medical emergency
• Premature rupture of membranes: The amniotic sac breaks before labor begins, leading to early delivery
• Preterm labor and delivery: Labor beginning before 37 weeks of pregnancy
• Stillbirth: Death of the baby before or during delivery
• Miscarriage: Loss of pregnancy before 20 weeks

How Do Drugs Affect the Developing Baby?

All drugs that you take during pregnancy reach your baby through the placenta. This can cause birth defects, restrict growth, damage the developing brain, and lead to long-term cognitive and behavioral problems. The severity of effects depends on the type of drug, amount used, frequency of use, and timing during pregnancy.

The placenta does not act as a barrier against drugs. Instead, almost all substances that enter your bloodstream will cross the placenta and reach your developing baby. Because your baby is so small and their organs are still developing, they are extremely vulnerable to the toxic effects of drugs.

The developing brain is particularly sensitive to drug exposure. Brain development begins early in pregnancy and continues throughout, with different structures forming at different times. Drug exposure at any point can disrupt this delicate process, potentially leading to permanent changes in brain structure and function.

Growth restriction is another common consequence of prenatal drug exposure. Drugs can interfere with nutrient delivery to the baby, alter hormonal signals that regulate growth, and directly damage growing tissues. Babies exposed to drugs often weigh less at birth and may be smaller overall, which can have lasting health implications.

Effects on the Baby's Brain Development

The developing brain is extraordinarily sensitive to substances that affect the nervous system. Drugs alter the chemical signals that guide brain development, potentially causing permanent changes in brain structure and function. The consequences of prenatal drug exposure on brain development can include:

• Language development delays: Children may be slower to speak and have difficulty with language comprehension
• Learning difficulties: Problems with memory, attention, and processing new information
• Attention and focus problems: Increased risk of attention deficit disorders
• Impulse control issues: Difficulty regulating behavior and emotions
• Behavioral problems: Increased aggression, anxiety, and difficulty with social relationships

These effects may not be immediately apparent at birth but often become noticeable as the child grows and faces the cognitive demands of school and social interaction. Early intervention and support can help children overcome some of these challenges, but prevention through avoiding drug use during pregnancy is the most effective approach.

Neonatal Abstinence Syndrome (NAS)

Babies who are exposed to certain drugs during pregnancy, particularly opioids, can develop neonatal abstinence syndrome (NAS) after birth. This occurs because the baby's body has become accustomed to the drug while in the womb, and experiences withdrawal symptoms once the drug supply is cut off after delivery.

Abstinence means the body has adapted to the presence of the drug and reacts negatively when it's no longer available. Newborns with NAS may be irritable, cry excessively, have tremors or shaking, sweat profusely, sleep poorly, have a rapid heartbeat, and struggle to feed properly.

Babies with NAS require specialized care in a hospital, typically for several weeks. Treatment may include medication to manage withdrawal symptoms, a calm and quiet environment, gentle handling, and careful feeding support. With proper care, most babies recover, though some may have longer-term developmental effects.

Heart and Organ Damage

Beyond brain effects, drugs can damage other developing organs. The heart is particularly vulnerable, with stimulants like cocaine and methamphetamine associated with an increased risk of congenital heart defects. Other organs, including the kidneys, lungs, and digestive system, can also be affected by prenatal drug exposure.

The timing of drug exposure matters significantly for organ development. The first trimester is when major organs are forming, making this a particularly vulnerable period. However, drug use at any stage of pregnancy can cause harm, as organs continue to grow and mature throughout pregnancy.

When and Where Should I Seek Help?

Contact your prenatal care provider (midwife or obstetrician) as soon as possible if you are pregnant and using drugs or struggling to stop. You can also reach out to addiction treatment services directly. Healthcare providers maintain confidentiality and can connect you with specialized support without judgment.

If you are pregnant and need help stopping drug use, the first step is to reach out for support. Many women feel ashamed or afraid of judgment, but healthcare providers who work with pregnant women are trained to help with these situations in a supportive, non-judgmental way.

Your prenatal care provider—whether a midwife, obstetrician, or family doctor—is an excellent first point of contact. They can assess your situation, provide immediate guidance, and connect you with specialized services. They are accustomed to handling sensitive issues and will focus on helping you and your baby get the best possible care.

If you've used drugs early in pregnancy before knowing you were pregnant, don't let guilt prevent you from seeking care. The most important thing now is to stop using and get prenatal care as soon as possible. Being honest with your healthcare provider allows them to monitor your pregnancy appropriately and address any concerns.

Healthcare Providers Maintain Confidentiality

All healthcare professionals are bound by confidentiality laws and ethical obligations. You can disclose your drug use and ask for help without fear of this information being shared inappropriately. Healthcare providers understand that addiction is a medical condition, not a moral failing, and their goal is to support you in achieving the best outcomes for yourself and your baby.

In most cases, the focus of healthcare providers is on treatment and support, not punishment. Laws and policies vary by location, but the medical community's approach is increasingly focused on providing compassionate care rather than punitive measures. If you have concerns about specific policies in your area, you can ask your healthcare provider directly about confidentiality.

Specialized Prenatal Care

Pregnant women who use or have used drugs are often referred to specialized prenatal care programs. These programs provide comprehensive support that addresses both your pregnancy needs and your substance use. A specialized team may include midwives, obstetricians, addiction specialists, social workers, and mental health professionals working together to support you.

Specialized care ensures more frequent monitoring of your pregnancy, early detection of any complications, and coordinated support for your recovery. The team approach means that all aspects of your care are integrated, reducing the burden of navigating multiple separate services.

Addiction Treatment Services

Addiction treatment centers and clinics provide professional support for stopping drug use. Treatment options may include outpatient counseling, intensive outpatient programs, or residential (inpatient) treatment, depending on your needs and circumstances. For pregnant women, many programs offer specialized tracks that address the unique needs of pregnancy.

Some women may need a period of residential treatment to safely stop using drugs. This provides a structured, supportive environment where you can focus entirely on your recovery while receiving medical supervision and support.

What Treatment Options Are Available?

Treatment options for drug use during pregnancy include medication-assisted treatment (MAT) for opioid dependence, cognitive behavioral therapy (CBT), motivational interviewing, group therapy, and residential treatment. The best approach depends on the type of drug, severity of dependence, and individual circumstances. Treatment significantly improves outcomes for both mother and baby.

There are many effective treatments available to help you stop using drugs during pregnancy. The right treatment depends on your individual situation, including the type of drug you're using, how long you've been using, and your personal circumstances. Working with healthcare providers, you can develop a treatment plan that addresses your specific needs.

Treatment for substance use during pregnancy is effective. With appropriate support, many women successfully stop using drugs and go on to have healthy pregnancies and healthy babies. The key is to start treatment as early as possible and to stay engaged with your support system throughout pregnancy and beyond.

Medication-Assisted Treatment (MAT) for Opioid Dependence

For pregnant women who are dependent on opioids (heroin, fentanyl, prescription opioids), medication-assisted treatment (MAT) is the recommended standard of care according to the World Health Organization, American College of Obstetricians and Gynecologists, and other medical authorities.

MAT involves using medications such as methadone or buprenorphine to manage opioid dependence. These medications prevent withdrawal symptoms, reduce cravings, and allow you to function normally without the risks associated with continued illegal drug use. Studies show that MAT improves pregnancy outcomes, increases the likelihood of engaging in prenatal care, and reduces risky behaviors.

While babies born to mothers on MAT may still experience some withdrawal symptoms (NAS), these are generally milder and easier to manage than withdrawal from illegal opioids. The benefits of MAT significantly outweigh the risks of continued opioid use or abrupt discontinuation.

Behavioral Therapies

Behavioral therapies are a cornerstone of addiction treatment and are often combined with medication when appropriate. These approaches help you understand the patterns and triggers of your drug use, develop coping strategies, and build a foundation for long-term recovery:

• Cognitive Behavioral Therapy (CBT): Helps identify and change thought patterns and behaviors that contribute to drug use
• Motivational Interviewing: A collaborative conversation style that strengthens your motivation and commitment to change
• Contingency Management: Provides tangible rewards for maintaining abstinence
• Network Therapy or Couples Therapy: Involves your partner, family, or support network in your treatment
• Relapse Prevention: Teaches skills to recognize and cope with high-risk situations

Support Groups

Peer support can be an invaluable part of recovery. Support groups connect you with others who understand what you're going through and can provide encouragement, practical advice, and a sense of community. Many women find that combining professional treatment with peer support provides the most comprehensive foundation for recovery.

Various organizations offer support groups specifically for people struggling with addiction. These include 12-step programs, SMART Recovery, and groups specifically for women or pregnant women. Your treatment provider can help you find appropriate support groups in your area or online.

What Can I Do Myself to Stop Using Drugs?

While professional help is often needed, you can support your recovery by identifying triggers, building a support network, avoiding people and places associated with drug use, creating a structured routine, and focusing on your motivation—your baby's health and your future as a parent.

Drug use creates both physical and psychological dependence. While professional support and sometimes medication are often necessary to overcome addiction, there are also important steps you can take yourself to support your recovery. Some people do manage to stop using drugs on their own, though this depends on your situation and the type of drugs involved.

The most important factor in recovery is your own desire to stop and your commitment to change. Focusing on your pregnancy and your future as a parent can provide powerful motivation. Visualizing the life you want for yourself and your child can help strengthen your resolve during difficult moments.

Practical Strategies for Recovery

Here are some strategies that can help you stop using drugs and maintain your recovery:

• Understand your triggers: Identify the situations, emotions, or people that trigger your urge to use drugs. Understanding these patterns is the first step to changing them
• Create a crisis plan: Write down specific actions you can take when you feel a strong urge to use, such as calling a supportive friend, taking a walk, or using a relaxation technique
• Change your environment: Avoid places and people associated with your drug use. Seek out supportive relationships and environments where drug use is not present
• Build a support network: Tell trusted friends and family members about your situation so they can support you. Having people who understand and can help is crucial
• Create structure: Establish routines and fill your time with meaningful activities. Boredom and unstructured time can be triggers for drug use
• Focus on your future: Create a vision of the life you want for yourself and your child. Breaking this into small, achievable goals can make it feel more attainable

What Happens After My Baby Is Born?

After birth, your baby will be monitored for withdrawal symptoms and receive any needed treatment. You'll continue to receive support for your recovery, including postpartum care, addiction services, and parenting support. Many women need ongoing support to avoid returning to drug use, and this support is available.

The journey doesn't end when your baby is born. Many women find the postpartum period challenging, and the risk of returning to drug use can be particularly high during this time due to stress, sleep deprivation, and hormonal changes. Continued support is essential for maintaining your recovery and providing the best care for your baby.

Your healthcare team will monitor your baby after birth for any signs of withdrawal or other effects of prenatal drug exposure. If your baby does experience withdrawal symptoms (neonatal abstinence syndrome), they will receive specialized care to manage these symptoms. Most babies recover well with appropriate treatment.

Continued Support for You

Support doesn't stop after delivery. You can expect continued support from your healthcare team, addiction services, and potentially social services if needed. This may include regular check-ins, ongoing counseling, medication management (if applicable), and practical support with parenting.

Staying connected to your support network is crucial during the postpartum period. Don't hesitate to reach out if you're struggling or feeling tempted to use drugs. The people who supported you during pregnancy are there to help you afterward as well.

Why It's Important to Look Forward

If you used drugs during pregnancy, you may feel guilt or shame. Remember that the past cannot be changed, but your future can be. The most important thing is to stop using drugs now and focus on giving yourself and your baby the best possible future. Every day without drugs is a step toward better health for both of you.

If you have used drugs during your pregnancy, you may feel terrible about it. Perhaps you didn't know you were pregnant, or perhaps you struggled to stop. Feelings of shame and guilt are common, but dwelling on the past doesn't help you or your baby.

The probability of harm is lower if you used only small amounts on isolated occasions. What matters most now is avoiding further exposure. Even if you've used drugs throughout pregnancy, stopping now still provides benefits for your baby's final weeks of development and for your recovery.

Focus on moving forward. Every day that you don't use drugs is a day your baby is protected from further harm. Every step you take toward recovery is a step toward being the parent you want to be. Help is available, and recovery is possible. The most important thing is to take that first step and keep moving forward.