Dealing With Addiction While Pregnant

A baby born an addict may have to spend weeks in the hospital recovering.
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An addiction to drugs or alcohol isn't healthy for any woman, but if she's pregnant, the dangers quickly multiply. When harmful substances enter the mother's bloodstream, they pass through the placenta and umbilical cord, which is an unborn baby's lifeline.

Even if a mother ingests only a small amount of drugs or alcohol while pregnant, it will stay in her baby's bloodstream long after it has passed out of her own. And it will affect the baby to a greater degree because it can disrupt his precise developmental timetable [source: American Pregnancy Association].

An expecting mother's addiction to drugs or alcohol creates a precarious existence for her baby -- one that could end in miscarriage. If the baby does survive the mother's drug abuse, he may be born prematurely, with fetal alcohol syndrome (a condition caused by exposure to alcohol and characterized by facial deformities, central nervous system disruption and slowed mental and physical development) or with other health and mental issues. He could have malformed or missing limbs or deformed internal organs. And if the mother has shared needles with an infected user, the baby could be born with the human immunodeficiency virus (HIV) [source: National Institute on Drug Abuse, Medline Plus].

Pregnancy can be overwhelming in even the best of circumstances, but it's especially hard to make good decisions under the influence. However, there's one thing that every expecting mother who's suffering from addiction can do: Ask for help. Getting clean and sober during pregnancy -- even if it's late in the game -- is better than not doing it at all. And with knowledgeable care, the baby can be saved from being born an addict and going through painful withdrawal after birth [source: RehabCenters.net].

If illegal substances fuel a mother's addiction or if she's in her second or third trimester, it's only natural that she'll be concerned about the consequences of fessing up. Research shows that women who are afraid they'll be prosecuted or have their children taken away are less likely to seek prenatal care and treatment for their addiction [source: Advocates for Pregnant Women].

Will her health care provider report her to the authorities? It depends on where she lives. Some states, such as Iowa, Minnesota and North Dakota, require health care providers to test for and report the drug use of pregnant women. Others, such as Kentucky, are only required to test. Others yet, such as South Dakota and Wisconsin, use the results of drug testing to send pregnant women to inpatient treatment programs [source: American Pregnancy Association]. However, by seeking help with her addiction, she may save her baby's life.

Find out what her treatment might entail on the next page.

Getting Treatment

If a pregnant woman is addicted to drugs or alcohol, she shouldn't quit cold turkey. It may be a natural, knee-jerk reaction, but it could be dangerous for her baby. The sudden withdrawal could cause in-utero seizures or result in miscarriage [source: Goodnough]. Instead, she should seek professional help right away so her treatment can begin safely.

She can expect to be methodically weaned off the addictive substance or given an alternative drug that will act as a crutch during the withdrawal process. For example, the clinically supervised withdrawal of pregnant users of opiates (like heroin or oxycodone) may involve steadily decreasing doses of methadone or buprenorphine, which are synthetic drugs used as less addictive substitutes [source: Drugs.com]. Slowly cutting the dosage results in less severe withdrawal symptoms for both mom and baby [source: National Institute on Drug Abuse]. Unfortunately, even legally prescribed withdrawal drugs like methadone have been linked to birth defects, such as congenital heart problems, but a health care provider will help the mother choose the best treatment for herself and her baby [source: Centers for Disease Control and Prevention].

Facilitating a physical withdrawal is an important element of the treatment process, but it's only part of the equation. A recovering addict also needs to learn a new way of life. Outpatient recovery programs include daily or weekly meetings, but participants must have a high level of internal motivation to succeed.

Inpatient treatment may be a more effective option, especially for pregnant women in the throes of addiction who only have a few weeks left to safeguard their babies' development. Inpatient rehabilitation programs monitor abstinence from drugs or alcohol closely and offer an abrupt break from potential triggers, like certain social situations, people or stressors that could cause a relapse during those first fragile weeks of recovery [source: McCarthy].

Weeks-long supervised treatment also increases the odds that the recovering addict will get to the root of the problem. Sometimes, addiction stems from a failed attempt to self-regulate a mental health disorder. Studies show that pregnant women with mood or anxiety disorders are more likely to use drugs or alcohol to quell the symptoms, and that the use of illegal substances has a cyclical effect because it causes lingering mood and anxiety issues [source: National Institute on Drug Abuse].

If an expecting mother has undiagnosed depression, she may be prescribed antidepressants as she works to become clean and sober. Although some antidepressants pose a risk to her unborn baby, others are considered safe during pregnancy. For example, some selective serotonin reuptake inhibitors (SSRIs), such as Zoloft and Prozac, have been linked to fetal heart and lung defects but are still considered for pregnant women because the risk of these defects is relatively low. Other antidepressants, such as Wellbutrin, have not been shown to damage a baby's development [source: Mayo Clinic].

A health care provider will need to understand the woman's medical history and mental state thoroughly to weigh the risks of potential treatments versus the benefits.

On the next page, find out what a mother in recovery can do to keep getting better.

Staying Healthy

Group meetings allow fellow patients to shoulder each other's burdens -- and share each other's triumphs.
Group meetings allow fellow patients to shoulder each other's burdens -- and share each other's triumphs.
Paul Sutherland/Digital Vision/Thinkstock

Once an expecting mother has enacted a treatment plan to mitigate the damages of addiction to her baby and herself, it's time to make her commitment stick. After the initial push to become clean and sober, she can expect to face a lifetime of temptations. The adage "take it one day at a time" offers apt advice as she continues to recover -- and as she encounters the many thrills and stresses of motherhood.

There are many things that a recovering addict can do to help prevent a relapse. For starters, she should encircle herself with support. Staying clean and sober, especially during the first few months, requires a daily (sometimes hourly) recommitment. There's no shame in leaning on the people who are there to help, whether they're friends, family, fellow members of a 12-step group or addiction treatment professionals, counselors and psychologists. It's equally important to steer clear of the people, events or activities that could trigger old habits [source: Borchard].

In the inevitable moments when she's alone with her thoughts, it may help to take several minutes of quiet time to visualize her life as a drug-free mother [source: Mater Mothers' Hospital]. Alternatively, she could take daily breaks from her thoughts and embrace an activity that moves her literally and physically toward good health, such as walking or swimming [source: Borchard].

To bolster her resolve, she can visit recovery Web sites with chat forums moderated by addiction professionals. If she finds herself itching to use drugs or alcohol, she should reach out to volunteer-staffed hotlines like the National Drug Help Hotline (800-662-44357) or the National Alcohol and Drug Dependence Hopeline (800-622-2255).

The stack of books on her bedside table can reflect her new focus, too. Books like "7 Tools to Beat Addiction," by Stanton Peele, and "Alcoholics Anonymous: The Big Book," by AA Services, are good places to start.

Organizations like Alcoholics Anonymous and Narcotics Anonymous offer tools, resources and meetings that can help as she transitions from intensive treatment to real life. In addition, many treatment facilities offer aftercare programs that help a recovering addict adjust to her new life. These programs can include supervised living arrangements, counseling and group meetings.

Aftercare should include mental health therapy, such as cognitive behavioral therapy or dialectical behavioral therapy. Cognitive behavioral therapy is based on the premise that when you change the way you think about your circumstances, you change the way you react to them [source: Kadden]. Dialectic behavioral therapy also relies on mental reframing, but focuses on simultaneously promoting good behavior and accepting lapses in it without losing hope [source: National Institutes on Drug Abuse].

As a recovering addict's new life as a mom takes hold, she should congratulate herself on how far she's come. Battling addiction is difficult, but no one is in it alone. By asking for help, an expecting mother will have the support necessary to ensure that both her and her baby can embrace the health and happiness they deserve.

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Sources

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