When a baby is born it's a joyous occasion that usually comes with familial celebrating, tears aplenty, and smiling faces doting on the newest addition to the family. After the little one takes his first breath, and cries his first cry, he is held by his parents' outstretched, hungry arms; he is comforted, cuddled, and made to feel safe. When a baby is born it's usually the happiest day parents can remember. Except when it isn't-
Sadly many women and their babies have a very wholly different experience. Picture a different scene: A drug-addicted mother struggles to give birth, her health already poor and her dope-wracked body now in absolute distress because of the effects of her severe addiction. She once was a businesswoman with a bright and promising future, who went to work every day, came home to a house that she owned, and enjoyed her life with friends and family. But now, her health has been in freefall for a long time; living on the streets takes a significant toll, and the nurses, who try to remain kind, can see it written in every deep line carved across her face. She hasn't had any proper pre-natal care, because she was worried about disclosing her drug use to medical professionals. But now there's no hiding it. Somehow, she's now made it to a hospital emergency room, and the doctors and nurses are doing their best to stabilize her, administering drugs to help stave off symptoms of withdrawal just long enough for her to give birth. One final, gut-wrenching push and the baby is born. While they put mom back on oxygen, everyone wants to hear the baby take its first breath and cry out--the universally understood sound that means a new life has arrived. But they wait. And they wait. And they wait. Nurses vigorously rub the baby, trying to stimulate it to breath but there's only silence and the beeping of the oxygen monitor. The faces of the doctors say what doesn't need to be said. Sadly this is an all-too familiar scene in America. According to a 2012 study, about 6 percent of pregnant women in the United States use illicit drugs while they are pregnant, which creates a whole host of debilitating obstacles for the baby that will follow for the rest of its life, if it survives at all.
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Research shows that use of tobacco, alcohol, illicit drugs, or prescription opioids by pregnant women can have severe health consequences for infants. This is because there is very little barrier between mother and unborn child; many substances pass easily through the placenta, so just about any substance that a pregnant woman ingests, injects, drinks, or smokes also reaches the vulnerable fetus. Recent research shows that smoking tobacco or marijuana, taking prescription pain relievers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth, and recent estimates suggest that about 5 percent of pregnant women use more than one addictive substance!
When a baby is born to a drug-addicted mother, the baby experiences symptoms of withdrawal—quite similar to what an adult would feel if they were detoxing—except a baby's system is far more fragile and less equipped to deal with them. This condition is called "Neonatal Abstinence Syndrome" (referred to as NAS for short) and refers to the group of conditions at large that are caused when a baby withdraws from certain drugs he's been exposed to in the womb before birth. Short-term conditions infants can experience from being born addicted include blotchy skin coloring, diarrhea, excessive or high-pitched crying, abnormal sucking reflex, fever, hyperactive reflexes, increased muscle tone, irritability, poor feeding, rapid breathing, seizures, sleep problems, slow weight gain, stuffy nose and sneezing, sweating, trembling and vomiting. But as horrible as all of these short-term symptoms are, babies born to women who have drugs in their system can also face far, far worse long-term effects, including birth defects, low birth weight, premature birth, small head circumference, and sudden infant death syndrome (SIDS.)
Using any substance while pregnant massively increases the risk of having complications, including stillbirths. The statistics are alarming.
Mothers who use tobacco products are 1.8 to 2.8 times at greater risk of having a stillbirth, with the highest risk found among the heaviest smokers.
Mothers who regularly use marijuana products are 2.3 times at greater risk of having a stillbirth.
Mothers who abuse stimulants, marijuana, or pain relievers are at 2.2 times greater risk of stillbirth.
Mothers who are around tobacco users but do not use themselves are still at 2.1 times greater risk of having a stillbirth.
Cocaine, sometimes known as "crack," is a highly addictive drug. 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, and death of the mother. Women who use cocaine have a 25% higher chance of having a preterm birth.
If heroin is used during pregnancy, it can cause preterm birth, fetal death, addiction in the fetus, and significantly stunted fetal growth. Studies of children of women who used heroin during pregnancy showed that some children were smaller, had trouble thinking clearly, and also had behavioral problems.
Many PCP users become violent and out of control, which can present problems during delivery. Babies exposed to PCP during pregnancy may be smaller than normal and have poor muscle control. Babies exposed to ketamine during pregnancy may have learning problems. LSD users may have violent behavior and flashbacks during pregnancy, and use of LSD may also lead to birth defects in the baby.
The sniffing of 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 debilitating heart defects.
Pregnant women who use amphetamines may not get enough nutrients for their growing fetus. Amphetamine use can also cause placental abruption (resulting in massive bleeding) or even fetal death.
Many of the risks users face with ecstasy are similar to 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.
Imagine if you will, a different hospital birthing scenario than the one described above. Imagine that in that same hospital room, born to that same drug addicted mother, the baby got lucky and actually lived. Image that after the nurses vigorously rubbed its back, trying to resuscitate it, the baby finally took its very first breath, and cried out. Everyone breathed a sigh of relief! Yet, still a silent killer was still lurking, directly because of the mother's substance abuse. A couple months later, while sleeping in its crib, the baby's breathing stops inexplicably. No one notices, because mom is exhausted and asleep on the couch. Children born to mothers who both drank and smoked beyond the first trimester of pregnancy have a twelvefold increased risk for sudden infant death syndrome (SIDS) compared to those unexposed or only exposed in the first trimester of pregnancy.
We know that heroin use during pregnancy can have some of the most serious ramifications of any of the illicit drugs. As described above, it can cause premature separation of the placenta from the uterus (which results in massive bleeding,) an underweight or premature baby, or stillbirth. And sadly, the effects tend to follow the children their entire lives. Studies have shown that children who are exposed to heroin in utero are more likely to demonstrate inattention and cognitive impairment, and to display disruptive behavior in school or more structured settings. Medication-assisted treatment during pregnancy and delivery may help to reduce these negative outcomes.
If a woman is addicted to heroin and becomes pregnant, medical professionals will often prescribe her a synthetic drug called Methadone, to help wean her off of the incredibly strong high-to-dope sick-cycle of heroin use. It does not provide quite the same high as heroin, and methadone is considered far safer than heroin because its longer half-life reduces cravings and the risk of withdrawal, which is important because the ups and downs associated with heroin are considered extremely hazardous—and sometimes deadly--for a fetus. Methadone is also only manufactured under closely controlled conditions, so it's thought to be far less dangerous than street drugs, which are often "cut" or mixed with low-quality ingredients so that drug dealers can bulk up their supply. Women who are successfully treated with methadone also tend to demonstrate fewer of the negative and risky behaviors associated with heroin use, like prostitution, and consequently face far fewer health risks such as HIV transmission. All of these factors predict far better outcomes for the baby.
Dependence on alcohol and drugs (or both) can often (sadly) be a "canary in the coal mine" for predicting how a baby's home life will be. Misuse of alcohol and other drugs can severely impair an individual's functioning as a parent, spouse or partner, and instigate and trigger domestic violence, thus significantly affecting the physical, mental and emotional development of children. Because of this unfortunate trend, when a baby is born to a mother with drugs in her system, usually state agencies become involved shortly thereafter, and the ability of the drug addicted mother to care for the infant is assessed. If she's found to be unable to properly care for her newborn, the baby is usually placed in foster care for a time. Nationally, about a third of children entering foster care do so due to parental drug abuse, according to 2016 data. Currently, eighteen states classify maternal drug use as child abuse, and three states consider it as reason for involuntary hospitalization, disincentivizing women from seeking treatment.
There is a slightly different way to look at drug use in pregnancy. Sometimes the risk of a baby potentially being taken away due to maternal drug use can be a major motivator to get clean.
Pregnancy may be an opportunity for women, their partners and other people living in their household to change their patterns of alcohol and other substance use, since pregnancy usually is accompanied by far more interaction with medical professionals than normal. Health workers providing care for women with substance use disorders during pregnancy need to understand the complexity of the woman's social, mental and physical problems in order to provide the correct advice and support throughout pregnancy and the postpartum period. In one study, 83 percent of pregnant women who were using cigarettes, alcohol, cocaine, or marijuana, were able to stop during pregnancy, though relapses afterward were very common. Another study shows that women who are allowed to stay with their children during treatment are more likely to start treatment and maintain abstinence.
So, where can you get more information to help you find the assistance you need? If you or someone you love is pregnant and is struggling with a drug or alcohol addiction, there are multiple resources at your disposal. First, begin by asking your healthcare provider about treatment options available to you. They should be able to direct you to a nearby facility that can provide support and potentially the methadone or other substances you may require to help you get clean.
Additionally, you can visit SAMHSA's (Substance Abuse and Mental Health Services) website treatment locator online, to find a medical facility nearest you with the services you need. The most important thing is to acknowledge the problem and take this first, important step towards saving the life of your baby. Nothing could be more precious. And quite possibly, getting clean to protect your baby's life may very well save your own life as well.