Substance Misuse and Pregnant Women

Judging, shaming, and stigmatizing individuals are proven to be ineffective approaches for healthy, productive, and lasting change. Instead, they serve as proverbial weapons that tear at the core of an already-fragile human condition—a condition that strives to be valued, to matter, and to be loved. Pregnant women are no exception.

A woman battling substance misuse needs help. A woman struggling with substance misuse, who happens to be pregnant, also needs help and requires a specific type of care.

A substance use disorder (SUD) is defined as a reoccurring use of drugs and/or alcohol that leads to clinically serious impairment, which may be inclusive of disability, health problems, and failure to meet one’s responsibilities at home, work, or school, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Pregnancy, Women, and Substance Misuse

Substance misuse, whether it’s alcohol, illicit drugs, or misusing prescriptions such as opioids, impacts many Americans.

In 2022, among the 137.4 million individuals aged 12 or older, who were current alcohol users, 44.5% of them were past month binge drinkers.¹ According to a Morbidity and Mortality Weekly Report, released in January of 2022 by the Centers for Disease Control and Prevention, nearly 14% (or 1 in 7) pregnant people reported current drinking; 5% of those individuals (or 1 in 20) reported binge drinking in the past 30 days.²

Despite varying guidelines, there is simply no safe amount of alcohol consumption during pregnancy.³ While many women, upon finding out they are pregnant, will stop drinking, there are some women with alcohol use disorder (AUDs), who may continue to drink. Unfortunately, in an effort to manage their risk of being discovered by health professionals or those in the criminal justice system, women who drink while pregnant—or use other substances, such as opioids—may isolate themselves, skip treatment appointments, or avoid treatment altogether.⁴

However, there are a number of adverse health consequences for mothers and babies when alcohol or drug use continues during pregnancy.

The mother’s use of alcohol during any stage of pregnancy can manifest in several different birth defects collectively referred to as fetal alcohol syndrome disorders (FASDs), which can impact the physical and structural development of the fetus and manifest in a number of ways, including:^3,5-7

• Abnormal facial characteristics.
• Small head circumference.
• Below average height and weight.
• Problems with eyesight or hearing.
• Bone, heart, and kidney issues.

The good news is that alcohol dependency and alcohol use disorder in pregnant individuals is relatively rare. However, if medical advice and behavioral interventions aren’t successful in stopping alcohol use, the individual will need specialized counseling and additional medical support to quit drinking, which may mean medical supervision in an inpatient rehab facility that offers a program for the treatment of pregnant people.⁸

Continued misuse of opioids during pregnancy can lead to adverse consequences for mothers and baby, too, including:^9,10

• Miscarriage.
• Preterm birth.
• Stillbirth.
• Poor fetal growth and development.
• Birth defects.
• Neonatal abstinence syndrome (NAS), which includes a cluster of manageable withdrawal symptoms in infants.
• Maternal death.

Similarly, treatment can help pregnant women, with opioid use disorder, and their unborn babies during pregnancy. The health risks to both mother and child can be minimized with evidence-based treatment. Medication combined with prenatal care and a comprehensive treatment program can improve the chances of delivering a healthier baby.⁶

The bottom line: It’s never too late to seek treatment for a substance use disorder during pregnancy. However, in order for women with substance use disorders to feel comfortable asking for help, primary care physicians and mental healthcare providers need to offer a safe space, free from judgement, shame, and stigma to provide guidance and assess and evaluate each patient.

If you struggle with substance misuse and are pregnant, you’re not alone. American Addiction Centers (AAC) is the nationwide leader in addiction treatment, and we provide treatment with a compassionate medical staff to help both women and men get on the road to recovery. Call to speak to a compassionate and knowledgeable admissions navigator, who can listen to your story, explain your options, and answer your questions.