The December 2017 issue of The Journal of Pediatrics published a study of maternal substance abuse and infant outcomes in the state of Massachusetts from 2003-2010.
It was no surprise to learn that babies born to mothers with substance abuse disorders had more health problems and were likelier to be born prematurely or at a lower birth weight. Doctors and the general public have known about the potential effects of maternal drug and alcohol use on developing fetuses for decades.
Despite increased knowledge of the effects of substance abuse on unborn babies, however, rates of drug use among pregnant women went up from 2003 through 2009. The greatest increase in usage rates was for opioids, and there is little reason to believe that rates have fallen since 2009, considering that opioid use has increased since then.
Potential Effects of Maternal Substance Abuse on Babies
Use of drugs and alcohol by pregnant women is associated with numerous adverse outcomes for their children. Babies are more likely to be born pre-term, and those carried to term are likelier to have low birth weight. During gestation, babies of mothers with substance abuse disorders are likelier to experience intrauterine growth restriction, and once they are born, they are at higher risk for cardiac, respiratory, neurological, and feeding problems, and they have higher infant mortality rates than babies born to women without substance abuse disorders.
Mothers with Substance Abuse Disorders Often Have Fewer Resources
The pregnant women who are likeliest to have substance abuse disorders are also likely to be younger, to have completed fewer years of education, to be unmarried, and to be without health insurance. In other words, the very women and children who could benefit most from access to prenatal care are often ones who have the least access to it.
Finally, there is the uncomfortable fact that the numbers assessed by the recent study were self-reported numbers, so there isn’t really a way to know if they’re accurate. It’s safe to say, however, that people are likelier to report they don’t have a substance abuse disorder when they do have one than the other way around.
Why Pregnant Women May Refuse to Seek Help
It is not always lack of resources that keeps pregnant women from seeking the prenatal care they and their babies need. Twenty-four states and the District of Columbia consider the use of drugs during pregnancy as child abuse, and 23 states and the District of Columbia require healthcare professionals to report suspected prenatal drug use. Only 19 states have created or funded drug treatment programs for pregnant women, though some states prioritize placement of pregnant women in treatment programs.
In a nutshell, many women refuse to seek prenatal care for fear of being arrested or having their children taken away from them. The result is higher risks to babies and less chance of pregnant women with substance abuse disorders receiving the treatment they need.
Asking for Help Can Lead to Caring Assistance
Having seen firsthand how criminalizing drug use during pregnancy turns women away from care for themselves and their unborn babies, many doctors are fighting back on behalf of their pregnant patients. Some states have rolled back enforcement of laws related to drug use during pregnancy, and pregnant women can safely participate in monitored, medication-assisted treatment for withdrawal from opioids.
Pregnant women with substance abuse disorders should not fear going to jail if they reach out for help with their addiction. The few states that still enforce laws targeting pregnant women with addictions often drop charges against women who complete treatment programs.
Reaching out for help with substance abuse can be frightening under any circumstances, and doing so while pregnant can be particularly upsetting. However, there are resources available to help pregnant women get the help they need so they and their babies can be healthy and happy. If you are pregnant and have a substance abuse disorder, please reach out. Help is confidential, and you can be directed to the best care for both your addiction and your pregnancy. We encourage you to contact us at any time if you have questions or need to talk about your unique situation.
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