Patient education: Alcohol and drug use in pregnancy (The Basics)

Can alcohol and drugs cause problems during pregnancy? — Yes. If you want to get pregnant, it's best to stop drinking alcohol and using drugs before you start trying. This is important because:

●Even small amounts of alcohol or certain drugs can be harmful to a developing baby.

●A person might not know that they are pregnant for the first few weeks of their pregnancy.

If you want to get pregnant, it's also important to talk to your doctor or nurse about any prescription medicines you take or other substances you use, such as cannabis. Some medicines are not safe during pregnancy.

What problems can happen if I drink alcohol during pregnancy? — Babies of mothers who drink alcohol during pregnancy can have fetal alcohol spectrum disorder ("FASD"). This condition affects brain development and growth. Compared with normal babies, babies with FASD tend to weigh less, have smaller heads, and be very fussy. When they grow up, they have life-long problems with thinking and behavior.

Drinking alcohol during pregnancy can also increase the risk of pregnancy loss or "stillbirth." Pregnancy loss, also called "miscarriage," is when a pregnancy ends before 20 weeks. Stillbirth is when a baby dies before it is born, in the second half of pregnancy (after 20 weeks).

Because of these risks, doctors recommend completely avoiding alcohol during pregnancy. No amount of alcohol is known to be safe during pregnancy.

What problems can happen if I take drugs during pregnancy? — That depends on which drug you take, when you take it, how much you take, and for how long. Not everyone who uses drugs during pregnancy has extra problems. But many people and their babies do.

The problems can also depend on other things, like whether you smoke cigarettes or drink alcohol in addition to using drugs.

Doctors do not know for sure exactly what each drug does to a pregnancy or a growing baby. That's because it is a very hard thing to study. If you use more than 1 drug and have problems during pregnancy, it can be hard to know for sure which drug caused which problem. The more drugs you use, the higher your risk of problems.

To be safe, doctors recommend that pregnant people avoid all illegal drugs, as well as certain drugs that are legal but can cause problems.

There is evidence that the following drugs can cause specific problems:

●Heroin or other opioid pain medicine – Using heroin during pregnancy increases the risk for many serious problems. For example, people who use heroin during pregnancy can get infections that also affect the baby. The babies of mothers who use heroin can also be born weighing less than normal or with a serious problem called "neonatal abstinence syndrome." These same problems can happen if a pregnant person takes prescription pain medicines called "opioids." These include morphine, oxycodone, and fentanyl.

●Cocaine – People who take cocaine during pregnancy are more likely to have problems with the placenta. The placenta is the organ that forms between the mother and baby during pregnancy. It brings the baby nutrients and oxygen and carries away waste. Using cocaine can cause the placenta to separate from the uterus before delivery. This can be harmful for the mother and baby.

Babies born to mothers who use cocaine during pregnancy have a higher chance of being born too early (called "premature") or being too small. These problems can affect the baby's feeding, sleeping, breathing, vision, and hearing.

●Cannabis – Cannabis (marijuana) is legal in some places. But doctors recommend avoiding it during pregnancy. That's because it might cause problems for the baby, either at birth or later in life. It is also possible that using cannabis during pregnancy raises the risk of other problems, such as premature (early) labor or having a baby that is smaller than normal. More research is needed to better understand how cannabis affects pregnancy.

What should I do if I am pregnant and already use alcohol or drugs? — If you are pregnant and drink alcohol or use drugs, it's not too late to make changes. A good first step is to talk to your doctor or nurse. They can give you advice on the best and safest ways to quit for your and your baby's health.

If you use alcohol, heroin, or opioid medicines, stopping suddenly can be dangerous for you or your baby. Your doctor or nurse can help you stop alcohol or drugs safely, so that your baby can be as healthy as possible. As part of this process, you might need to take certain medicines. Your doctor or nurse can also help you contact counselors or other people you can talk to for support.

More on this topic

Patient education: Fetal alcohol syndrome (The Basics)
Patient education: How to plan and prepare for a healthy pregnancy (The Basics)
Patient education: Alcohol use — when is drinking a problem? (The Basics)
Patient education: Alcohol and your health (The Basics)
Patient education: Cannabis use disorder (The Basics)
Patient education: Cocaine use disorder (The Basics)
Patient education: Prescription drug misuse (The Basics)

Patient education: Risks and benefits of alcohol (Beyond the Basics)