Use of illegal drugs can be harmful to the health of your baby. If you use them, you may fear that you will not be able to stop. But with help, you can. You are not alone, and there are ways to get help. This pamphlet will explain:

How drugs can affect your fetus How drug use can affect you How to get help

When you use illegal drugs, so does your baby. If you stop now, you can give your baby a better chance to be born healthy.

Drug Use and Pregnancy

Illegal drug use is widespread. It affects people of all backgrounds. As many as 1 in 10 babies may be born to women who use illegal drugs during their pregnancies. These substances can be harmful to the health and growth of your fetus during pregnancy. If you are using any of them, you should stop before you get pregnant.

How Drugs Can Affect Your Baby

Your drug use can affect your baby both before and after birth. Most drugs reach the fetus by crossing the placenta. This is a thick pad of tissue inside the uterus that provides nourishment to the fetus. If you use drugs after your baby is born, they can be passed to him or her through your breast milk.

Different drugs may affect the fetus in different ways. A drug's effect on the fetus depends on many things: how much, how often, and when during pregnancy you use it. If two or more drugs are taken together, it can be hard to predict the effects. Sometimes the drugs add to or even increase each other's effects.

Using drugs can cause problems throughout your pregnancy. For instance, the early part of pregnancy is when the main body parts of the fetus form. Using drugs during this time in pregnancy can cause birth defects and miscarriage. During the last 12 weeks of pregnancy, illegal drug use poses a risk for stunting fetal growth and causing preterm birth and fetal death.

How Drugs Can Affect You

Drug use may have long-term effects for your own health as well as your baby's. For instance, injecting drugs with needles that have been used by others increases your risk of getting hepatitis B virus or human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS). These viruses then also can be passed to your baby.

Types of Drugs

Marijuana

Marijuana, also called grass or pot, can be smoked or eaten. Some studies have found that babies born to women who used marijuana while pregnant were smaller and, therefore, more likely to have health problems, than babies born to women who did not use marijuana. As with cigarette smoke, your fetus is exposed to the marijuana smoke you inhale. The effects of marijuana use during pregnancy, no matter how it is taken, are not well known, so it is best not to expose your fetus to it.

Cocaine

Cocaine, sometimes known as "crack," is a highly addictive drug. It can be used by injection with a needle, through the nose (snorting), or by smoking (freebasing).

A pregnant woman's cocaine use may cause the placenta to detach from the uterus too soon (placental abruption). This can cause problems, such as:

• Severe bleeding
• Preterm birth
• Fetal death
• Maternal death

Using cocaine while you are pregnant can lead to high blood pressure or sudden death from stroke or heart attack. People who use cocaine can become dependent (hooked) on it.

Heroin

Heroin is smoked or is injected under the skin (also called "skin popping") or into the veins ("mainlining"). If heroin is used during pregnancy, it can cause:

Preterm birth Fetal death Addiction in the fetus Stunted fetal growth

Studies of children of women who used heroin during pregnancy showed that some children were smaller, had trouble thinking clearly, and had behavioral problems.

People who use heroin become addicted to it. They may use it in greater and greater amounts, which can cause death from overdose.

Methadone is a prescription drug often used in drug treatment centers to help reduce a person's dependence on heroin. Women in methadone treatment programs take methadone instead of heroin to help them maintain a healthier lifestyle than women who are addicted to heroin. However, methadone use is not risk free. This medication should be used only under a doctor's care or in a drug treatment center.

PCP, Ketamine, and LSD

PCP, or angel dust, most often is smoked. It also can be eaten, snorted, or injected. PCP can cause a user to lose touch with reality. It also can cause flashbacks, seizures, heart attacks, and lung failure leading to death. Many PCP users become violent and out of control. Babies exposed to PCP during pregnancy may be smaller than normal, and have poor muscle control.

Ketamine, or Special K, most often is snorted or eaten. It also can be injected. The effects of ketamine are like those of PCP. However, ketamine is less potent and the effects do not last as long as those of PCP. Ketamine can cause a type of amnesia. This means that users may forget what happened while they were on the drug. Babies exposed to ketamine during pregnancy may have behavioral or learning problems.

LSD, or acid, is taken by mouth. It can cause hallucinations—hearing and seeing things that do not really exist. LSD users may have violent behavior and flashbacks. During pregnancy, use of LSD may lead to birth defects in the baby.

Glues and Solvents

Glues and solvents sometimes are inhaled or sniffed to give a quick "high" feeling. This also is called "huffing." The use of these substances can cause lightheadedness, dizziness, and even sudden death. They also may damage the liver, kidneys, bone marrow, and brain. The sniffing of these fumes during pregnancy may cause birth defects in the baby, such as short height, low weight, small head, problems with joints and limbs, abnormal facial features, and heart defects.

Amphetamines

Amphetamines, also called uppers or speed, are taken in pill form. They can make the user feel nervous and irritable and can keep the user from being able to sleep. These drugs also can cause loss of appetite. Pregnant women who use amphetamines may not get enough nutrients for their growing fetus. Amphetamine use can cause placental abruption or even fetal death. Users can become dependent on amphetamines. If this happens, they can take too much of these drugs and become very ill or die from an overdose.

Methamphetamine ("meth") is a type of amphetamine. It can be snorted, swallowed, smoked, or injected. Babies exposed to methamphetamine may:

• Have intrauterine growth restriction, or IUGR (grow too slowly in the womb)
• Have trouble bonding with others
• Have tremors
• Be very fussy

Crystal methamphetamine ("crystal meth") is a very potent type of amphetamine. It has the same risks as amphetamines and methamphetamines for a woman and her baby.

Ecstasy

Methylenedioxymethamphetamine (MDMA), or ecstasy, is taken in pill form. In many people, this drug produces a feeling of happiness, but also can cause feelings of anxiety and depression. Many of the risks users face with ecstasy are like those found with the use of cocaine and amphetamines, including changes in mood, sleep problems, and loss of appetite. If a pregnant woman takes ecstasy, her child may have long-term learning and memory problems.

Do You Have a Drug Problem? Sometimes it can be hard to tell the difference between drug use and drug abuse. Experts in treating alcohol abuse use the CAGE questions below to help them find out whether a person has a drinking problem. These questions can apply to other drugs, too. C  Have you ever felt you ought to Cut down     on your drinking? A  Have people Annoyed you by criticizing your     drinking? G  Have you ever felt bad or Guilty about your     drinking? E  Have you ever had a drink first thing in the     morning to steady your nerves or get rid of a     hangover? An Eye opener? If you answer yes to any of these questions, or if you notice an increased tolerance to alcohol or drugs, you may have a problem. (Ewing JA. Detecting alcoholism: the CAGE questionnaire. JAMA 1984;22:1905–1907; Copyright 1984, American Medical Association)

Addiction

Drug addiction usually disrupts your home, family, and work life. Addiction begins when a person chooses to use drugs, but addiction is not just "a lot of drug use." At some point, changes occur in the brain that can turn drug abuse into addiction, a chronic illness. Those addicted to drugs have intense cravings to use drugs. Usually drug addicts cannot quit by themselves and treatment is needed to end this behavior.

A short test can help you find out whether you have a problem with drug use (see box). Even if you think you do not have a drug problem but sometimes use drugs, you still should quit. Any drug use can harm your fetus.

Some people fear that they cannot function without using drugs. People who use drugs need support while they are being treated. This will help them to look at the reasons for their drug use, to know that they are not alone, and to find new ways to cope.

Drug treatment programs also can help. Ask your doctor for information or a referral. You also can check your phone book or ask at your social service agency.

How Can I Get Help

The groups listed below help people with drug abuse. If you or someone you know has a drug problem, seek help.

Narcotics Anonymous
World Service Office in Los Angeles
PO Box 9999
Van Nuys, California 91409
Telephone: (818) 773-9999
Fax: (818) 700-0700
Web site: www.na.org

Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
5600 Fishers Lane
Rockville, Maryland 20857
Telephone: 800-662-HELP
Fax: (301) 443-8751
Web site: findtreatment.samhsa.gov

Finally...

When you use illegal drugs, so does your baby. Women who stop drug use during their pregnancies have healthier babies than those who do not. Women who enter a drug treatment program and get prenatal care also have healthier babies. If you stop now, you can help yourself to live without drugs. You also can give your baby a better chance to be born healthy.

Glossary

Acquired Immunodeficiency Syndrome (AIDS): A group of signs and symptoms, usually of severe infections, occurring in a person whose immune system has been damaged by infection with human immunodeficiency virus (HIV).

Hepatitis B Virus (HBV): A virus that attacks and damages the liver, causing inflammation, cirrhosis, and chronic hepatitis that can lead to cancer.

Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body's immune system and causes acquired immunodeficiency syndrome (AIDS).

Placental Abruption: A condition in which the placenta has begun to separate from the inner wall of the uterus before the baby is born.

Preterm Birth: Born before 37 weeks of pregnancy.

This Patient Education Pamphlet was developed under the direction of the Committee on Patient Education of the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women's health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as "superior." To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet 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 © August 2002 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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