Substance Use Among Pregnant Women

Drug and alcohol use has far-reaching impacts to not just the individual struggling with dependence and addiction, but to family, friends, and the community. This is especially true for individuals who are pregnant and living with addiction.

Pregnancy and Addiction

Drug and alcohol use aren’t healthy choices for anyone, but when it comes to pregnant mothers, the effects can have long lasting impacts on her baby. However, one of the hallmarks of addiction is continuing to use substances despite the negative harmful effects to a person’s life, health, and relationships.

According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH), in 2019:

  • 5.8% of pregnant women surveyed reported past month illicit drug use.
  • 9.5% of pregnant women surveyed reported past month alcohol use.
  • 5.4% of pregnant women surveyed reported past month marijuana use.
  • 0.4% of pregnant women surveyed reported past month opioid use.
  • 0.2% of pregnant women surveyed reported past month cocaine use.

The Biology of Pregnancy

Throughout pregnancy, fetal development is occurring at a rapid pace. In the first trimester alone, a number of important functions and changes are taking place. These include:

  • Closing of the neural tube.
  • The beginning of brain development.
  • Formation of eye lenses.
  • Arms, legs, and joints start to form.
  • Ears take shape.
  • The liver starts to produce red blood cells.
  • Genitalia forms.

During the period when the baby’s liver and brain are just starting to develop drug or alcohol use by the mother carries significant risks to development.

If a mother has her pregnancy continue through the first trimester when the risk of miscarriage is at its highest – 10-20 percent of pregnancies end via miscarriage, per Mayo Clinic – then the risks segue further toward birth defects than fatality. Fetal alcohol spectrum disorders are the largest presumed risk, which the Centers for Disease Control and Prevention notes an approximate 2-5 percent of American first graders suffer from.

Babies who are exposed to prenatal drug use from substances like opioids or methamphetamines typically suffer from the effects of withdrawal after birth. The symptoms of this can range from pain in the body and insomnia to severe dehydration and seizures – far more than a newborn body is equipped to deal with. The National Institute on Drug Abuse states a baby is born suffering from neonatal abstinence syndrome every 25 minutes in the United States.

Marijuana abuse is also increasingly common among pregnant mothers. The Journal of the American Academy of Pediatrics reports smoking cannabis produces five times as much carbon monoxide than cigarette smoking does, which is already known to be highly toxic to a developing fetus. Down the road, the National Institute on Drug Abuse reports that 5-year-old children who were exposed to methamphetamines prenatally are more aggressive and destructive, and more likely to have attention issues.

What About Mom?

Of course, the detrimental effects of drugs and alcohol don’t only harm developing babies, but their mothers too. Side effects of substance use span from physical health issues and mental illness to causing families and careers to fall apart.

Beyond the typical side effects incurred via substance abuse, abusing drugs or alcohol while pregnant can have additional repercussions for the pregnant mother and her relationship with her child. When a baby is born addicted to an illicit substance, Child Protective Services is often called upon to intervene. In many cases, newborns are immediately removed from their mother’s custody.

Pregnant women should be aware of the potential for increased risks of postpartum anxiety and postpartum depression following delivery of their children when substance use occurred while pregnant. It’s important to talk to your doctor about the risks of postpartum anxiety or depression and to have resources available to you.

Getting Help for Drug or Alcohol Use

Don’t be afraid to reach out for help while pregnant. There are treatment facilities that cater to moms-to-be and help them to not only get on the road to recovery, but also to prepare for the arrival of their baby.

Continued support can be found through a number of avenues. Joining face-to-face support chapters like Alcoholics Anonymous isn’t the only option for today’s mothers. SMART Recovery and Women for Sobriety both provide online outlets for mothers who need peer support and encouragement to stay clean. There are even online support forums where mothers in recovery can reach out to connect with others who struggle with the same issues.

Aside from support groups, therapy can go a long way in aiding to prevent relapses down the road. Evidence-based therapies, such as cognitive behavioral therapy, are beneficial to the majority of people in recovery from an addiction by teaching them how to cope with the stressors that led them to substance abuse in the past in healthier ways.

One of the biggest hurdles pregnant mothers face when getting treatment for substance use disorders is detox. Depending on what type of substance was used, certain measures may or may not be available to a woman while she is pregnant due to the risks they can pose to the developing child. However, several medications used routinely during detox are safe to use while pregnant, such as antidepressants and low-risk pain relievers. To mitigate the risk of serious side effects to the mother, which in turn affects the baby, tapering schedules may be enforced to wean the mother off substances slowly.


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