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Risk of Abusing Drugs and Alcohol During Pregnancy

David Hunter, MA.Ed, LPC

Medically reviewed by

David Hunter, MA.Ed, LPC

March 21, 2019

The number one cause of preventable birth defects is alcohol and drug use during pregnancy. Exposure to these substances in the womb, even in moderation, can cause a lifetime of physical, mental, intellectual, and social problems.

To better understand the risks of drug and alcohol use during pregnancy, it helps to know how the fetus and mother are intimately connected via the placenta. Although the mother’s and fetus’s blood never directly mix, the placenta serves as the conduit to transfer life-giving nutrients from the mother’s blood. Only a thin membrane separates the mother’s blood vessels from the fetus’s umbilical cord vessels, and this membrane is permeable. This is a good thing, as it is the only way the fetus receives sustenance like oxygen and nutrients from the mother. However, molecules of alcohol and drugs can also pass through, directly entering the fetus’s bloodstream.

With drugs, the effect is often to constrict the blood vessels in the placenta or lower the mother’s blood pressure too much, both of which make it harder for the fetus to receive nutrition and oxygen. This stunts the growth of the fetus as it is literally starved for air and food. Drugs can also affect the developing central nervous system as well as every other vital organ in the body.

In the case of alcohol, the fetus receives a blood alcohol concentration (BAC) equal to or even higher than the mother. Since the liver is one of the last organs to fully form, the fetus is not developed enough to process the alcohol as quickly as the mother’s body. If she continues to drink, the fetus will end up with a ‘backlog’ of alcohol to process, making its BAC higher than the mother for longer than the mother. The inability to keep up can result in miscarriage and a range of birth defects.

Not all birth defects are immediately apparent. Many people assume if the baby ‘looks’ fine or doesn’t have extra appendages, then it must be healthy. Sadly, this is not the case. Many of the effects are not visible but can still cause serious impairment of physical, mental, emotional, or behavioral health.

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Effects of Alcohol and Drugs on the Child

At birth, the baby may exhibit immediate symptoms of exposure to alcohol and/or drugs. This can be apparent in pre-term birth, low birth weight, short limbs, abnormalities of the face, and other obvious defects. In other cases, the baby may experience withdrawal from drugs known as Neonatal Abstinence Syndrome, which can cause involuntary tremors and shaking, excessive crying and screaming, seizures, sleep problems, and other symptoms.

When we consider how drugs affect a developing fetus, we tend to lump them all together. Illicit drugs like cocaine, methamphetamine, opioids, hallucinogens, and marijuana can all have different effects. Many over-the-counter and prescription drugs, like blood pressure medication, anti-anxiety drugs or anti-depressants, can also be dangerous to a developing fetus. Women who are taking any drugs or medications, legally or not, should consult their doctor for more personalized risk information.

Physical Problems

The physical impairments a baby suffers due to alcohol or drug use depend on what stage of gestation the substance abuse occurred. There is no safe stage of pregnancy to use drugs or alcohol. Early use of alcohol results in a doubled risk of miscarriage. This is true even for women who drink a “moderate” amount of one to two drinks per week. So while you’re excited to plan your gender reveal and baby shower, it’s best to leave the champagne to the guests.

Physical problems associated with substance abuse include deformed limbs, slow growth, heart defects, kidney defects, vision and hearing problems, poor coordination, and a smaller head—and, thus, a smaller brain—which can affect a child’s well-being for his or her entire life.

Oftentimes, however, the damaging effects of these substances are not known for some time yet can persist forever. These lifelong side effects show up as the child grows older and begins interacting with the world around him or her.

Intellectual and Mental Problems

Using alcohol and/or drugs during pregnancy can result in a variety of intellectual, behavioral, and mental health issues. These range from a lower IQ, poor memory, and impaired reasoning skills to full-blown learning disabilities, attention problems, mood swings, language delays, and hyperactivity. These issues can make it harder for a child to do well in school, setting them up for a lifetime of hardship.

Other problems include an increased risk of depression, anxiety, schizophrenia, and ADHD.

Social Problems

Babies born to mothers who have used alcohol or drugs during pregnancy also face social problems. They are more likely to struggle with social interactions, school settings, job settings, and even staying out of trouble with the law. They may have a harder time making and maintaining friendships. They are also more likely to develop drug and alcohol problems themselves.

Fetal Alcohol Syndrome

Alcohol use, in particular, can result in a collection of all of the above symptoms, known as Fetal Alcohol Syndrome. FAS causes distinct facial abnormalities affecting the size of the head, the spacing of the eyes, the size of the lips, and other features. FAS is also known to cause a host of physical, intellectual, mental, and social problems.

While these lifelong deformities and health issues sound quite frightening, the good news is they’re entirely preventable. If you struggle to avoid alcohol or drugs during pregnancy, consult your doctor for help. Your doctor is there to help you and your baby be as healthy as possible.

***This article was written by Johnson Hur of

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