McKesson Clinical Reference Systems: Women's Health Advisor 2002.2

What is substance abuse during pregnancy?

Drugs, alcohol, and tobacco can harm your body and mind. If you are pregnant, these substances can also hurt your baby. They enter the baby's blood through the placenta. They can cause mental problems, birth defects, and problems before, during, and after birth.

What about street drugs?

Any street drug, especially one that can cause addiction, is dangerous. You are addicted if you cannot carry out your usual daily activities without it. If you are addicted to heroin or cocaine, your baby can become addicted. The baby will then have withdrawal symptoms after birth. You may neglect your own health care, increasing your unborn baby's risk.

Even if you just use drugs sometimes, you are at risk because the effects of drugs can be so harmful. Street drugs can cause you to have flashbacks, convulsions, heart attacks, violent behavior, and lung failure causing death. Use of street drugs can increase the risk of losing the baby, delivering the baby too soon, and having a small baby. Some babies may die while inside the uterus, and others may die after delivery. The babies who survive may have lifelong physical, behavioral, and emotional problems. They may have brain, liver, kidney, or bone marrow damage. They may be unusually fussy and may have uncontrollable body movements. Drugs can also cause premature separation of the placenta, which can cause sudden massive bleeding (hemorrhage). This bleeding can put the lives of you and your baby in danger.

If you are hooked on street drugs (angel dust, hashish, speed, LSD, peyote, cocaine, or marijuana), get help for your drug use before you become pregnant. If you are already pregnant, get help now. Ask your health care provider for advice and a possible referral to a treatment program.

What about prescription drugs?

Make sure you discuss the use of prescription drugs with your health care provider at your first prenatal visit. Some prescription drugs can harm an unborn baby. Be sure to tell anyone who prescribes medication for you that you are pregnant.

If you have an infection that may need an antibiotic, check with your health care provider. Some antibiotics are harmless. Others could hurt your baby. For example, tetracycline should be avoided during pregnancy. It may cause your child's teeth to be discolored and may affect growth of the child's bones. Avoid sulfa drugs near the end of your pregnancy. They may cause the baby's skin to become yellowed (jaundiced) in the first days of life.

What about nonprescription medicines?

Check with your health care provider before you use any medication. Some nonprescription medications are safe. Others can cause problems during early or late pregnancy.

If you have a fever, you can safely take acetaminophen (Tylenol) in the doses recommended on the package. Do not take it for more than 3 days without consulting your health care provider. Do not take aspirin.

For heartburn, ask your health care provider what antacids you are allowed to take. Most antacids are safe. Don't take too much of these drugs because they can cause constipation.

To relieve hemorrhoids, you can use Preparation H.

Ask your health care provider before you take any drug for a headache, cold, cough, or diarrhea. He or she can tell you what is most likely to be safe and effective for you and your baby.

What about alcohol?

Any alcohol you drink goes into your bloodstream and then through the placenta and into your baby's bloodstream. Pregnant women who drink alcohol risk having a child with birth defects. Fetal alcohol syndrome (FAS) is the term used for certain problems that a child may have if the mother drinks too much alcohol when she is pregnant. FAS affects a child's growth and causes heart defects, malformed facial features, and mental retardation.

No one knows how much alcohol, if any, is safe for a pregnant woman to drink. Regular drinking can harm your baby. There may be less risk if you drink infrequently and moderately. The more you drink during pregnancy, the greater the danger to your baby. Frequent alcohol users (one to two drinks or more per week) are much more likely to have children with FAS than women who drink less frequently during pregnancy. It is not clear that you must never drink alcohol during pregnancy to prevent FAS. However, because we do not know what level of alcohol becomes dangerous, drinking no alcohol at all during pregnancy is the only sure way to avoid any risk of problems from alcohol.

The best time to stop drinking alcoholic beverages is before you become pregnant. If you are pregnant and are still drinking, the time to stop is now. If you need help, ask your health care provider.

What about smoking?

Mothers who smoke are more likely to have small babies. These babies are more likely to have problems during labor and delivery. They also have a greater risk of developing health problems within a few months after birth. Smoking increases the risk of miscarriage, premature labor, stillbirth, sudden infant death syndrome (SIDS), and lifelong disabilities. In addition, there is a possible link between smoking by a mother and attention deficit disorder (hyperactivity) in children.

If you are a smoker, stop now, especially before the second half of your pregnancy, when your baby is growing the most. If you cannot quit completely, try to cut down to fewer than 10 cigarettes a day. Cutting down or stopping smoking during pregnancy reduces the risks. The risks are about the same for women who stop early in pregnancy as for women who are nonsmokers.

What about caffeine?

Coffee, tea, chocolate, some soft drinks, and some medications contain caffeine. Drinking caffeine during pregnancy is generally safe. However, women who drink more than five or six cups of coffee a day (600 milligrams of caffeine) are more likely to have low-birth-weight babies and stillbirth. There are some reported cases of increased miscarriages. To be on the safe side, limit the caffeine you have each day to less than 200 milligrams (1 or 2 cups of coffee).

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.