By: Shlomo Hoffman
Reviewed by: Susan F. Julius, MD, DABPM, DABFM, FASAM, CMRO

Addiction is a dangerous disease for everyone.  However, the risks for pregnant women greatly increase.  Pregnant women should be conscious of the fact that whatever they put in their bodies can reach the fetus and cause long term effects. You know that surgeon general’s warning telling you not to drink while you are pregnant? It’s not just there because there is a law saying they have to write it.  Children exposed to harmful drugs and alcohol in utero will often struggle with serious neurological and physical disorders for the rest of their lives.

While addiction treatment is recommended for anyone suffering from Substance Use Disorder (SUD), for a pregnant woman it is perhaps even more important. A safe environment during this delicate time is paramount for the health of both mom and baby. There are two lives at stake.

Health risks of pregnancy and addiction

The health risks associated with prenatal exposure to drugs and alcohol is long. The placenta, an organ that passes on oxygen and nutrition from mother to fetus, will transfer harmful substances as well.  Stillbirth and miscarriage rates rise. Respiratory illnesses and birth defects are common. Learning issues, developmental delays, and congenital disabilities are often a sad reality. Neonatal Opioid Withdrawal Syndrome (NOWS) is super dangerous and may be fatal. Data also suggests that babies exposed to addictive substances are more prone to Sudden Infant Death Syndrome (SIDS). Past the first semester it increases risk 12-fold.

Pregnancy in its simplest form is stressful. When combined with addiction treatment it can be overwhelming. A woman can have a million scary questions about what addiction treatment will mean for her health and the health of the life she is bringing into the world.  You may wonder if it is safe, what it entails, and if the clinicians will be sensitive to her condition. Will I have access to my ob-gyn and good prenatal care?  What are the legal consequences of admitting to Substance Use Disorder (SUD) while pregnant? Will anyone help me prepare for the awesome responsibility of caring for a child? Are medications used in addiction treatment healthy for my baby? Is detox an option at this point? Maybe I should just wait till after the baby is born and then concentrate on getting better?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870985/

These are all important and valid questions. Let’s address them.

FAQs

1. Is addiction treatment safe for pregnant women?

Yes! But do your research! Don’t be afraid to ask a treatment facility how their program will take care of your specific needs. Although there are some places you won’t feel comfortable with, there are many rehab locations that are fully prepared to give you the care you require. They will walk you through their protocol for detox, what medications are appropriate, and the measures they will take to keep you and your unborn child safe. Their clinicians will display sensitivity, empathy, and compassion throughout. Find a place staffed by people who care and who are prepared.

2. Is detox an option for pregnant women with addiction?

Withdrawal during pregnancy can be dangerous. It can cause early labor and other complications. Abstinence should not begin anywhere but in a medically supervised and professional environment. This will wean the body from the opiate dependence without shocking the system. New studies are uncovering other methods as well. There are new studies showing that detox can be accomplished if the outpatient follow-up is at a high level. Discuss these options with your doctor to see if it works for you. Due to the increased risk of relapse, the fact that two lives are at stake, and the potency of street drugs nowadays, Medication-Assisted Treatment (MAT) is the accepted way to treat pregnant clients in almost all cases (medications include:  Subutex, Suboxone, & Sublocade). Methadone is an accepted medication to use to treat Opioid Use Disorder in pregnancy but can only be obtained from a Methadone Treatment Program.

3.Will I have access to good prenatal care?

Any addiction rehab facility worth their salt works closely with a client’s ob-gyn. They will provide transportation, facilitate appointments, and closely monitor the baby’s health. A client should be checked every shift.

Additionally, the baby’s heart rate and other vitals will be constantly measured.

Some questions the staff will ask:

  • Do you feel the baby move?
  • Are you having contractions?
  • Are you having any vaginal bleeding?
  • Do you have loss of fluid/rupture of membranes?

4. Should you wait till after the baby is born?

Absolutely not! The best possible outcome will only be reached if you are safely in treatment. You can begin to practice recovery habits, gain confidence and self esteem and place the baby in the safest possible environment. Additionally, it is a place where counseling can help the family unit. In appropriate instances, the father of the baby can be involved through family therapy programs. A child born while mom is safely on the path of recovery will be granted the gift of stability and a better chance at success. Places like Avenues Recovery will even reach out to local charities and work with them to provide things the baby will need. If adoption is appropriate, they will help you navigate that too.

For a woman carrying a child and struggling with addiction, drug and alcohol rehab is the safest and best possible place to be. Give yourself and your expected bundle of joy the best chance at real happiness. You can be the best mom to your child. Find the addiction rehab facility that believes in you so much that you begin to believe it yourself!

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Brooke Abner,

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