Pregnancy and Substance Abuse

When you are pregnant, you are not just "eating for two." You also breathe and drink for two, so it is important to carefully consider what you give to your baby. If you smoke, use alcohol or take illegal drugs, so does your unborn baby.

It is no secret that babies born to drug addicted mothers are at great risk of harm.  The degree of harm depends on the type of drug, the amount of the drug and during which part of the fetal development that the drug is used.  Drug use during pregnancy greatly decreases the oxygen and blood flow that the fetus receives from the mother.  Since oxygen and blood flow is required for proper fetal growth, these pregnancies are at risk for miscarriage, babies born prematurely, babies born with low birth weight, or stillbirth.  A baby born to a drug addicted mother will more than likely have some withdrawal from the drug after birth.  These babies have a high pitched cry, easily startled and woken, irritable, are sensitive to lights and noises, and typically have feeding difficulties.  The babies born to these mothers are at risk for developmental delays and behavioral problems later in the child’s life.

I currently work in labor and delivery.  The drugs that I see used most often are marijuana, cocaine, and crystal meth.  Hopefully during prenatal care, the use of alcohol and/or drugs has been addressed.  If a mother presents to labor and delivery with an admitted use of drugs, we perform a urine drug screen and the baby is also screened, using urine or meconium.  Occasionally a mom will come in with no admitted drug use but has symptoms, namely preterm labor, sudden bleeding, or behavioral issues.  These mothers are also screened.  A mother who does not receive prenatal care will automatically be tested for drug use.  Typically a social worker is consulted to evaluate the case.  How the cases are handled vary from county to county, with some being stricter than others.  Dare County, for example is much more aggressive with the placement of the babies after discharge from the hospital.  While keeping babies with their mothers is important, it is not always the best option for the baby.  Safety of these babies must be a priority.  I have seen babies go home with mothers who are in no way able to take care of themselves, let alone a newborn, making follow up imperative.

Some characteristics of emotionally resilient families include:

• Adaptability – being able to cope with change
• Gratitude and Appreciation - thanking each other and helping each other
• Clear Roles – a parent(s) who don’t act like parents, or who don’t want to take on their responsibilities as parents, create confusion and conflict in the family
• Communication - being genuine/caring and willing to listen carefully and respectfully to the views of others
• Commitment - recognizing that everyone in the family circle has value and worth

To create resilient families we need to focus not only on our emotional but also on our physical and spiritual wellness as well.

Author: Ms. Sarah Hewitt, RN

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