FAQ Pregnancy
FAQ170, December 2013



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Tobacco, Alcohol, Drugs, and Pregnancy

Why is smoking dangerous during pregnancy?

If you smoke during pregnancy, your baby is exposed to harmful chemicals such as tar, nicotine, and carbon monoxide. Nicotine causes blood vessels to constrict, so less oxygen and nutrients reach the fetus. Carbon monoxide decreases the amount of oxygen the baby receives.

How can smoking during pregnancy put my baby at risk?

The risks of preterm birth and problems with the way the placenta attaches to the uterus are increased in women who smoke during pregnancy. Also, infants born to women who smoke during pregnancy tend to be smaller than those born to nonsmokers. They are more likely to have asthma, colic, and childhood obesity. They also have an increased risk of dying from sudden infant death syndrome (SIDS).

How can secondhand smoke affect my baby during pregnancy?

Breathing secondhand smoke—smoke from cigarettes smoked by other people nearby—can increase the risk of having a low birth weight baby by as much as 20%. Infants who are exposed to secondhand smoke have an increased risk of SIDS and are more likely to have respiratory illnesses than those not exposed to secondhand smoke.

What help is available if I want to quit smoking?

If you are pregnant and you smoke, tell your health care provider. He or she can help you find support and quitting programs in your area. You also can call the national "quit line" at 1-800-Quit-Now.

Can I use nicotine gum or the patch to help me quit smoking when I am pregnant?

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.

Why is drinking during pregnancy dangerous for my baby?

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.

What are fetal alcohol spectrum disorders?

"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.

What is fetal alcohol syndrome?

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

What amounts of alcohol can cause FAS?

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.

Is there an amount of alcohol that is safe to drink during pregnancy?

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.

What is illegal drug use?

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

How can my drug use affect my baby during pregnancy?

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.

How can drug use affect my baby after he or she is born?

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

Why is it important to tell my health care provider if I have used drugs during pregnancy?

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.

Will the results of my drug tests be kept confidential?

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.

What are some of the problems related to substance abuse?

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).

What is 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

Why is it important for pregnant women who are addicted to certain drugs, including pain medications and narcotics, to seek treatment to quit rather than quit on their own?

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

Can I take my prescription medication during pregnancy?

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.

Can I take over-the-counter medications during pregnancy?

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.

Glossary

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.

If you have further questions, contact your obstetrician–gynecologist.

FAQ170: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright December 2013 by the American College of Obstetricians and Gynecologists

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998