Maternal Drug Use During Pregnancy–Issues in Recovery
Maternal drug use during pregnancy poses significant challenges for mothers, their babies, families, treatment professionals, and society at large. There are issues involved that are common for all addicts and then issues specific to pregnancy while addicted. Overall, it is a difficult situation for all involved, but it can be managed in ways that reduce risks.
Everyone exposed to addictive substances is at risk for negative health effects. Substances are toxic, even one dose can cause adverse effects physically thought out one’s system. More frequent use, heavy use, and chronic use correlate to greater risks. For babies in utero, however, maternal drug use poses severe risks at any level of use. There has been a great deal of research about the toxic impact of maternal substance use on babies in utero. Sadly, many babies do not survive to full-term, and others do not survive their infancy due to such exposure. Substances such as cocaine, heroin, and alcohol are commonly abused and are only a few of many noxious addictive drugs. Just those are responsible for countless miscarriages, stillbirths, birth defects, and lasting neurological impairments among children exposed to them prenatally.
The Lingering Effects of Maternal Drug Use During Pregnancy
It is difficult to know the numbers of children affected by maternal drug use during pregnancy. Even among children with obvious histories of exposure and obvious problems, sometimes the origins of their problems are misunderstood. Research shows that children exposed to maternal substance use during pregnancy can be diagnosed with attention deficits, hyperactivity, attachment disorders, oppositional defiance, impulse control problems and conduct problems. Other problems that children have caused by maternal drug use during pregnancy include:
- Learning disabilities
- Relationship and interaction problems
- Motor skills, balance, coordination, and movement problems
- Cognitive delays and impairments such as low IQ, poor memory, difficulty focusing, poor reasoning, poor decision-making, and poor planning.
Addicted Women Have Unique Needs
Maternal drug use during pregnancy is fraught with many issues—not only physical and mental health complications, but social and cultural problems, and very often, legal problems as well. Addicted women are very different than addicted men in several respects. There are basic biological differences that include a greater sensitivity to addictive substances, for example. Women can become addicted more quickly and with lower doses of substances than men. Women are also prone to different craving and relapse triggers than men. Among factors contributing to this is body chemistry, particularly hormones, that can cause drug use to have different effects for them than for men. Hormonal issues can also impact recovery efforts, making cravings peak at points in the menstrual cycle, or reactive to pregnancy, breastfeeding, or menopause, for instance. Such biological issues are notably at work when an addicted woman is pregnant, posing unique treatment needs, apart from those experienced by addicted men.
Social and cultural issues for addicted women are distinct from those many addicted men face as well. Women report social and cultural roles, stigma, pressures, and issues that are gender based, and that set them apart from their male counterparts. For example, women are more typically expected to be the primary caregiver of children even when in active addiction. And, even though addiction causes usual standards of conduct to erode for everyone at some point, addicted women are often held to a higher moral standard than addicted men. Consequently, there can be a great deal of stigma and shame for addicted women that addicted men do not experience in the same ways.
Addicted women are also more vulnerable to interpersonal violence and victimization such as in domestic battering and other assault. Addiction dramatically decreases anyone’s ability to plan for safety and to execute safety plans. It also impairs judgment and can lead to decisions to be in unsafe places with unsafe people. Additionally, many victims of domestic violence find themselves unable to enter or stay in rehab due to their abusers’ manipulation. In the case of maternal addiction during pregnancy, both the woman and her unborn child are unsafe in such situations.
Legal issues are also, unfortunately, a part of an addicted and pregnant woman’s life. Child protection laws deem exposing an unborn baby to addictive drugs to be nonprotective, neglectful and/or abusive. Typically, testing is done when a baby is delivered that can show evidence of drug exposure in utero. Healthcare professionals are legally and ethically to report such findings to law enforcement and/or child protection agencies.
Health Risks for Addicted Pregnant Women
Certainly, children exposed to maternal drug use in utero are not the only causalities of addictive drug toxicity in those situations. Their mothers are as well. Some of the adverse health effects caused by addiction for pregnant women include:
- Elevated blood pressure, hypertensive crisis, stroke
- Cardiac, respiratory problems
- Neurological problems
- Panic attacks, anxiety, depression, PTSD
- Infectious disease
- Labor and delivery complications
The Other Costs of Maternal Drug Use During Pregnancy
Maternal drug use during pregnancy has wide ranging consequences, even beyond the mother, child, and other family members who bear the emotional brunt of it. There is also a large societal impact in many realms that are measured in various ways. One telling statistic is focused only on the medical costs of newborns withdrawing from opioids. In 2012, for example, now five years ago in a devastating opioid epidemic that continues, treating addicted newborns in the U.S. cost almost 316 million dollars. This figure says nothing of newborns affected by other addictive drugs, or the medical costs involved in ensuring their survival.
Other costly factors of maternal drug use during pregnancy include the effects of substance exposure for children who later have special medical, protective, and psychiatric needs because of it. Drug exposed newborns are apt to have birth defects as well as neurological and psychological ‘fallout’ throughout development and even later life. Meeting their needs, for example, can include special services for physical and mental difficulties as well as educational issues. Also, child protection agencies intervene, and services such as foster care and adoption agencies bring other economic burdens. Apart from the economics of the situation, there is the immeasurable and extensive emotional toll upon all involved when a newborn is impacted by maternal drug use during pregnancy; not the least of whom is deeply affected is the mother herself.
Recovering from Drug Use During Pregnancy
Addicted women who are pregnant require specialized treatment. The baby’s health and survival depend upon medical supervision during prenatal stages, and it is specific to the substances used. For example, women addicted to opioids cannot abruptly stop using without endangering themselves and their unborn babies. They must take medications such as methadone or buprenorphine as substitutes or replacements for their drugs of addiction until the baby is born. Withdrawal still occurs when women and infants stop the replacement therapy, and close medical supervision is required for that to occur successfully, too. However, replacement therapy during pregnancy helps reduce fetal distress. It also helps the mother reduce her exposure to any illicit drug culture she may have been involved in, thus improving her quality of life during pregnancy.
Additionally, recovery for women who are pregnant during addiction can be fraught with many heavily laden emotional issues. There is typically a great deal of shame and guilt for women who become pregnant when using substances. They have the societal stigma to cope with, as well as pressures from those closest to them. Being labeled an ‘unfit mother’ is a heavily stigmatizing dilemma which compounds the more common stigma of addiction in general. Consequently, treatment and recovery efforts will find such women challenged to cope with these powerful emotional issues.
Many women who have been addicted during pregnancy will also have an additional set of overwhelming issues to deal with in treatment and recovery if their children are born with impairments, die, or are removed from their custody by child protection agencies. It is obvious that these sorts of events are extremely painful. They are also stigmatizing, humiliating and shame-laden. Additionally, women in any such circumstance are grief-stricken, attempting to cope with what has happened in their babies’ short lives. It makes sense that women going through these experiences are traumatized and that efforts to get well can seem futile. The psychological pain alone that such women bear can make relapse to substance use almost an inevitability unless they receive the proper help.
There is Always Hope
Contrary to the hopelessness women in such painful situations may feel, treatment is beneficial, and recovery is possible. If you or a loved one is pregnant while addicted, you can find the right help to manage your pregnancy as safely as possible, and to go onto recover from your addiction. You can also find the right help to cope with the painful emotions of what is happening in your life overall. Professionals specially trained to treat addiction and psychological issues simultaneously (dual diagnosis specialists) can help you navigate your emotional distress successfully. Also, professionals trained to treat pregnant women who are addicted can help minimize the health risks to your baby and yourself. It takes a team effort to get you or your loved one and the baby through safely, but there are people who can answer your call for help who have the expertise and knowledge of resources to meet those special needs.
No matter what stage of pregnancy you or a loved one is in, and no matter how serious the drug use has been, treatment is beneficial. Risks and damage can be reduced with prenatal medical intervention, and sobriety is achievable. While the process can be a long one, it can also be a successful one for mother and baby. Pregnant addicted women have a dual task: to successfully deliver their babies as healthfully as possible and to reclaim their lives from active addiction. Many decisions must be made along the way, and most often, many challenges overcome. However, the support and guidance of a professional team can be had and is invaluable. Women must make a difficult step in reaching out for help and overcoming the guilt and shame they feel. However, being honest about their situations, and accepting help will best ensure their babies survive and thrive. It also best ensures that they themselves can be successful and well.