Tobacco, Alcohol, Drugs, and Pregnancy

Nicotine replacement (such as nicotine gum or the patch) or prescription medications for quitting smoking need to be used with caution during pregnancy. Over-the-counter nicotine replacement products should be used only if other attempts to quit have not worked and you and your health care provider have weighed the known risks of continued smoking against the possible risks of these products. Smokeless tobacco, electronic cigarettes, and nicotine gel strips are not safe substitutes for cigarettes.

When a pregnant woman drinks alcohol, it quickly reaches the fetus through the placenta. In an adult, the liver breaks down the alcohol. A baby’s liver is not fully developed and is not able to break down alcohol.

“Fetal alcohol spectrum disorders” is a term that describes different effects that can occur in infants when a woman drinks during pregnancy. These effects may include physical, mental, behavioral, and learning disabilities that can last a lifetime.

Fetal alcohol syndrome (FAS) is the most severe alcohol spectrum disorder. FAS can cause growth problems, mental or behavioral problems, and abnormal facial features.

FAS is most likely to occur in infants whose mothers drank heavily (3 or more drinks per occasion or more than 7 drinks per week) and continued to drink heavily throughout pregnancy, but it also can occur with lesser amounts of alcohol use. Even moderate alcohol use during pregnancy (defined as one alcoholic drink per day) can cause lifelong learning and behavioral problems in the child.

There is no safe level of alcohol use during pregnancy. Alcohol can affect the fetus throughout pregnancy. It is best not to drink at all while you are pregnant. If you did drink alcohol before you knew you were pregnant, you can reduce the risk of further harm to the baby by stopping drinking.

Illegal drug use includes the use of heroin, cocaine, methamphetamines, and marijuana and use of prescription drugs for a nonmedical reason.

A drug’s effects on the fetus depend on many things: how much, how often, and when during pregnancy it is used. The early stage of pregnancy is the time when main body parts of the fetus form. Using drugs during this time in pregnancy can cause birth defects and miscarriage. During the remaining weeks of pregnancy, drug use can interfere with the growth of the fetus and cause preterm birth and fetal death.

Drugs used after the baby is born can be passed to the baby through breast milk.

It is important to be honest so that you get the help you need for yourself and your unborn baby. Drug testing of your hair or urine during pregnancy or during labor may be done if your health care provider suspects that you have used certain substances and if you have a complication during pregnancy or delivery that suggests drug use. The baby also can be tested after birth.

Some states consider drug use during pregnancy to be a form of child abuse. In some states, if a drug test result shows that you have used certain substances, it must be reported to state authorities. You should be informed about this testing and consent to it before it is done. How your consent is obtained also varies from state to state.

These problems include work, relationship, and family issues; drunk-driving arrests and car crashes; or medical problems caused by the substance. Substance abuse can lead to dependence (addiction).

Addiction is a disease with three or more of the following signs and symptoms:

• Tolerance—Not having the same effect with continued use of the same amount and the need to use greater amounts of the substance to get “high”
• Withdrawal symptoms after stopping use of the substance
• Using larger amounts of the substance or using it over a longer period
• Desire or unsuccessful attempts to cut down or control substance use
• Spending a great deal of time using or obtaining the substance or recovering from its use
• Reducing or giving up important social, work, or recreational activities because of substance use
• Continuing to use the substance despite knowing that you have a problem
• Making excuses to continue using the drug instead of meeting your home or work responsibilities

Withdrawal from these drugs can cause miscarriage or other harm to the fetus.

Some prescription medications are safe to take during pregnancy. Others have known risks. If you are taking a prescription medication and become pregnant, tell your health care provider. Do not stop taking a medication prescribed for you without first talking to your health care provider.

Medicines sold over the counter, including herbal supplements and vitamins, can cause problems during pregnancy. Pain relievers such as aspirin and ibuprofen may be harmful to a fetus. Check with your health care provider before taking any over-the-counter drug.

Fetal Alcohol Syndrome (FAS): A pattern of physical, mental, and behavioral problems in the baby that are thought to be due to alcohol abuse by the mother during pregnancy.

Fetus: The developing organism in the uterus from the ninth week of pregnancy until the end of pregnancy.

Miscarriage: Loss of a pregnancy that occurs before 20 weeks of pregnancy.

Nutrients: Nourishing substances supplied through food, such as vitamins and minerals.

Oxygen: A gas that is necessary to sustain life.

Placenta: Tissue that provides nourishment to and takes waste away from the fetus.

Preterm: Born before 37 weeks of pregnancy.

Sudden Infant Death Syndrome (SIDS): The unexpected death of an infant in which the cause is unknown.

Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy.