Learn Effects of Substance Use During Pregnancy

Effects of Substance Use During Pregnancy

By
Grace Ogren
February 11th, 2025
Clinically Reviewed by
Dr. Malasri Chaudhery-Malgeri, Ph.D.

Substances like alcohol, marijuana, and illicit drugs can greatly affect the mother and child during pregnancy and cause complications during and after birth. Sometimes, the mother isn’t aware of her pregnancy and may use substances as if she weren’t carrying. In any case, using substances while pregnant can alter the health of the mother, the fetus, and the baby as it grows in and out of the womb.

Knowing the effects of substance use beforehand can help those who know they’re pregnant or think they may become pregnant carefully assess the risks to plan ahead for a healthier birth and pregnancy.

Understanding Substance Use During Pregnancy

Substance use during pregnancy can look like taking drugs that aren’t approved for pregnant people, like alcohol. These drugs have been identified as dangerous for the mother and fetus or potentially harmful. 

Common substances used during pregnancy, whether done intentionally or not, include alcohol, nicotine, some prescription medications (like prescribed opioids), and illicit drugs like cocaine or heroin. Studies found roughly 5% of pregnant women use substances while pregnant1.

Much of what mothers consume while pregnant reaches their infant because the placenta is easily permeable—including addictive and non-addictive substances.

Effects of Alcohol Use During Pregnancy

Alcohol can have damaging effects on a developing fetus throughout each stage of pregnancy1, even before mothers realize they’re pregnant. Drinking while pregnant can cause Fetal Alcohol Syndrome Disorders (FASD), which includes Fetal Alcohol Syndrome and other birth defects caused by alcohol.

FASDs cause cognitive, physical, and behavioral damage2 that may show right after birth or later on in childhood. Alcohol can disrupt the development of vital organs, like the brain, heart, and how the body functions as a whole. Heavy drinking can cause the most damage, especially when it occurs throughout the entire pregnancy. But no amount of alcohol is safe during pregnancy2. And with many pregnancies not being planned, doctors recommend women not to drink even while they’re trying to get pregnant or think they might be2.

Children born with a FASD may have defining facial features, cognitive impairments, and related behavioral problems. 

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Effects of Tobacco Use During Pregnancy

Smoking while pregnant can harm the mother and baby3 in several ways. It can lead to:

  • Premature births
  • Low birth-weight even if the baby is to term
  • Damage to the baby’s lungs and brain
  • Birth defects
  • Higher risk of sudden infant death syndrome (SIDS)
  • A doubled risk for excessive bleeding at birth and during pregnancy

Smoking can also create issues with fertility3 for both the mother and father. Nicotine can affect the fetus throughout the whole pregnancy—some mothers give birth to healthy babies, but that doesn’t guarantee they can smoke through a second pregnancy and get the same results. Smoking while pregnant can even result in a stillbirth (a deceased baby born after 20 weeks). Quitting at any point during the pregnancy can reduce the likelihood of all negative effects.

Second-hand smoke can also cause damage. Pregnant mothers can reduce their risks by quitting smoking and limiting their exposure to second-hand smoke. 

Effects of Illicit Drug Use During Pregnancy

Using illicit drugs when pregnant can double or even triple the chances of a stillbirth1. These types of drugs include heroin, cocaine, methamphetamine, and psychedelics like psilocybin. Since drugs pass easily through the placenta and into the developing fetus, babies can be born reliant, and addicted, to the substance their mother used. This is called neonatal abstinence syndrome (NAS).

Neonatal Abstinence Syndrome: Symptoms and Recovery

NAS correlates to illicit or prescribed opioids used during pregnancy4. Babies born with NAS greet the world in a state of withdrawal, experiencing irritability, stomach issues, seizures, and trembling. Babies with NAS also cry excessively and with a higher pitch than normal.

Medical care can help babies detox4 from substances safely and with greater comfort. Some babies require benzodiazepines, morphine, or methadone to relieve symptoms. They can recover to full health.

Effects of Prescription Medication Use During Pregnancy

Some prescribed medications aren’t fit to use during pregnancy—doctors should make women well-aware of this if they’re trying to conceive or are already pregnant. When pregnant women take prescribed medications against doctor’s advice, or procure them from non-medicinal places, it can harm them and their baby. 

These medications include benzodiazepines, opioids, and stimulants like Adderall. Most medications, prescribed or over the counter, haven’t been well-studied in regards to how they affect pregnant women and babies. A study found 9 out of 10 pregnant women took medications1—many of whom don’t know how it might affect their developing fetus, which is why providing a list of all medications taken can help doctors identify any risks.

Some medications can cause NAS, like oxycodone. Other medications may cause no harm, but it’s best to let doctors make the final call.

Combined Substance Use and Its Effects

Using more than one substance, or polysubstance use, can create more pronounced health effects for the mom and baby. For example, a pregnant woman who smokes and drinks alcohol imposes greater health risks to herself and the baby than someone only smoking or only drinking. 

The more substances passing through the placenta to the baby, the more likely they’ll have a negative effect on their development and future health. The National Institute on Drug Abuse says1,

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.

Psychological and Emotional Impact on Pregnant Women

Taking drugs during pregnancy can have a host of emotional and psychological effects on women. They may feel low or depressed as a result of their substance use, especially when that combines with hormone fluctuations. Regular substance use can cause a cyclical effect, where highs are followed by extreme lows and cause someone to continue their use to mitigate the lows.

Impaired mothers may also struggle to bond with their baby once they’re born. Drug use can affect the parts of the brain that help mothers bond with their baby5, making it difficult for them to form a secure parental relationship. This can impact their connection and parenting style throughout the baby’s life.

Preventative Measures and Treatment Options

One of the first steps in preventing substance use during pregnancy is testing regularly (or as needed) for pregnancy if using substances—or don’t use substances at all if you’re hoping to conceive

Educating men and women on the dangers of substance use during pregnancy can help mothers and partners understand and evaluate risks, and then adjust their behaviors accordingly. Knowing these risks before pregnancy can help mothers adequately prepare and create a substance-free environment for their baby to form and grow.

If you’re struggling with an active addiction and become pregnant, you can attend recovery programs and rehabs specifically for pregnant women (there’s a lot!). These programs account for you and your baby, addressing your needs with appropriate medical care, therapies, and prenatal care to support a healthy, full-term pregnancy.

If babies are born with substance-related complications, hospital staff can initiate a detox for the baby with medications to ease their withdrawals. Some birth defects caused by substances can’t be treated or reversed, but medical care can treat some symptoms throughout the person’s life.

Support Systems and Resources

Friends, loved ones, and medical staff can offer key support for pregnant women, helping them navigate addiction treatment if needed, and the journey of pregnancy. Women can join various support groups too, like 12-Step peer meetings or non-12-Step groups like SMART Recovery meetings. Prenatal clinics may also offer support groups to educate women on child-raising, best practices for their health, and to connect women to resources for housing, mental health care, and other personal needs. 
If pregnant women need to detox and/or get addiction treatment, they can go to one of the many rehabs with specialized care for pregnant women. Some rehabs will also offer services and help for other children, helping pregnant mothers attend treatment when childcare needs may otherwise prevent them.

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