Alcohol and drug use in pregnancy

Cocaine use in pregnancy can affect you and your unborn baby in many ways. During the early stages of pregnancy, it may increase the risk of miscarriage.

Later in Pregnancy it can trigger early labour, it reduces blood flow to the placenta and causes poor growth. As a result, cocaine exposed babies are more likely to be born of low birth weight and have more health problems.

Low birth weight babies are at an increased risk of Sudden Infant Death Syndrome (Cot death) and lifelong disabilities.

Cocaine exposed babies are at increased risk of birth defects, including urinary tract and heart defects. Cocaine may also cause an unborn baby to have a stroke. This can result in irreversible brain damage and sometimes the baby will die in the womb (still birth).

Cocaine may cause the placenta to peel away from the wall of the uterus (womb) during pregnancy causing a large bleed. This is called a placental abruption. Immediate delivery by caesarean section is necessary.

Babies who are regularly exposed to cocaine before birth sometimes have feeding difficulties and sleep disturbance.

As newborns they may be irritable, jittery and they may startle and cry at the gentlest touch and sound. These babies may be difficult to comfort because they are suffering the effects of withdrawal from these drugs.

Generally, these behavioural disturbances are temporary and will resolve over the next few months.

The effects of ecstasy use during pregnancy are not fully known. It is thought that there may be an increased risk of heart defects and skeletal deformities.

Babies exposed to ecstasy may face some of the same risks as babies exposed to other forms of amphetamines, e.g. speed, crystal meth.

Some research but not all suggests these drugs increase the risk of birth defects including cleft palate and heart and lung defects.

These drugs also appear to contribute to pregnancy complications. These include high blood pressure which can slow down your baby's growth, by reducing blood flow to the baby.

Other complications can be abruption and premature birth. Being born too early can lead to breathing difficulties for your baby because their lungs are not fully developed.

Babies who are exposed to amphetamines appear to undergo withdrawal symptoms, including:

• Jitteriness
• Drowsiness
• Breathing Problems

Benzodiazepines are also known as sedatives or sleeping tablets. These are generally used to treat anxiety.  However, they are addictive and dependency can develop quickly making you unable to function 'normally' without them.

Benzodiazepines pass freely across the placenta to the baby. Benzodiazepine usage in pregnancy has been linked to facial abnormalities.  Use in early pregnancy has been associated with an increased risk of cleft palate.

Even moderate to high amounts of benzodiazepines used in pregnancy cause withdrawal symptoms in your baby. These withdrawal symptoms consist of:

• Breathing difficulties
• Disturbed sleep patterns
• Sweating and fever
• Feeding difficulties

High benzodiazepine use in the later part of your pregnancy can lead to your baby being born 'floppy' and slow to breath. Your baby may also have difficulty sucking and swallowing.

Pregnant women wishing to reduce their intake of these drugs should withdraw slowly with medical supervision.

Sometimes your GP may prescribe you an opiate based medication for pain relief. These include Codeine Phosphate, Dihydrocodeine or Tramadol.

These opiates will pass through the placenta to your baby. In other words if you take these drugs your baby also receives them.   All opiates, used over time, will cause dependency, even prescribed medications.

If you are pregnant and using Heroin or methadone they will also pass to your baby through the placenta.

If you experience withdrawal symptoms from opiates so will your baby.

If you use opiate based drugs do NOT just stop taking your medication. This may cause withdrawal symptoms to you and your baby. This may increase the risk of miscarriage or premature birth.

Pregnant women wishing to reduce their intake of these drugs should withdraw slowly with medical supervision.

Withdrawal from opiates

Babies whose mothers have been taking opiates may show signs of withdrawal from the drug, but can safely be treated in hospital.

Withdrawal symptoms, might include:

• Fever
• Excessive sneezing
• Trembling
• Irritability
• Vomiting
• Continual crying
• Occasionally seizures (very rare)
• Diarrhoea

These babies are also at increased risk of Sudden Infant Death (SIDS) or cot death

If your baby does suffer from withdrawal following birth the midwives and neonatal staff are trained to help you care for your baby.

Research has identified that cannabis use in pregnancy can affect brain development of the unborn baby.   It also shows that babies exposed to cannabis during pregnancy may be more likely to exhibit behavioural changes as older children.

When cannabis is smoked, it is estimated that it can give off three times as much tar and five times more carbon monoxide than smoking a tobacco cigarette.

If smoked with tobacco there is also an increased chance of your baby being smaller than average, increased risk of sudden death and many other pregnancy complications.

It is safe to stop smoking cannabis in pregnancy immediately, your midwife can help guide you to support and local addiction services.