Articles

Key takeaways

• Using illegal drugs during pregnancy can be harmful to your baby's health.
• Always talk to your healthcare team for professional support.
• Do not stop certain drugs suddenly without medical advice.
• Babies may need special care when they are born for withdrawal symptoms after birth.

The risks of illegal drug use in pregnancy

Using illegal drugs during pregnancy can affect your baby's health and development. It's important to understand these risks so you can get the right support.

Using illegal drugs like cannabis, ecstasy, cocaine, and heroin can pose serious risks. There are no illegal drugs that are safe in pregnancy, even in small amounts.

Almost all drugs can pass from you to your baby through the placenta, the organ that connects you both. This includes tobacco and alcohol.

Using drugs can create challenges for your baby's health, both before and after they are born. This might include going into labour too early (premature birth) or, in some very sad cases, stillbirth. We know this is difficult to read, but understanding the risks is the first step to getting the support you and your baby need.

Your baby is also more likely to require special care. They may be underweight and have problems with their development and growth. There are links between using drugs during a pregnancy, and that child experiencing lifelong cognitive (brain), behavioral, and physical challenges.

Specific drug risks

Using cannabis, cocaine, heroin, and amphetamines has been linked to your baby being born early (preterm birth) and having a low weight at birth. Using tobacco with these drugs is common and may contribute to the outcomes. Many of these drugs put your child at higher risk of learning, attention and memory difficulties in their younger years.

Evidence suggests that using cannabis, cocaine, amphetamines, LSD, or khat in the first trimester increases the risk of your baby having one or multiple birth defects. Because the evidence isn't clear, the safest approach for your baby is to avoid these drugs. Your healthcare team is there to help you with this.

Cocaine (including crack cocaine) and methamphetamine (speed, or ice) are powerful stimulants that affect the network of nerves in your brain and spine (your central nervous system). Using them during pregnancy may increase the risk of serious pregnancy complications. These include the placenta coming away from the wall of the womb (placental abruption), your waters breaking early (premature rupture of membranes) and premature labour and birth.

Cocaine, amphetamines, and MDMA can affect blood flow to the placenta. This could lead to your baby receiving less oxygen and reduced blood flow, increasing the risk of some birth defects. These drugs can also cross the placenta which can affect you baby’s developmental organs, such as their heart and brain.

Taking heroin (and other opioids like morphine or tramadol) when you are pregnant can affect both your health and your baby's. Whether heroin is smoked or injected, it still enters the bloodstream and crosses over to your baby. Using heroin in pregnancy can cause maternal vaginal bleeding and a low birth weight baby, both which are dangerous for you and your baby.

Babies can experience withdrawal symptoms when born. These can be mild, but are sometimes very serious. These symptoms can include sleep problems, irritability, seizures, tremors, and problems feeding.

Heroin use is also linked to an increased risk of sudden infant death syndrome (SIDS). This is a another reason why your healthcare team would like to support you in every way they can.

Injecting heroin or other drugs carries a risk of infection. You could contract viruses like HIV or Hepatitis B or C from sharing or using unsterilised needles. You risk passing the virus on to your baby.

Finding support to reduce or stop drug use

Now that you are pregnant, it’s an important time to think about your drug use and get support. Do not stop or reduce the amount of cocaine, heroin, or similar drugs (opiates or opioids) you take without speaking to a doctor first.

It is important to withdraw from these drugs in the right way to reduce the risk of problems for you and your baby. The safest way to quit is with medical help, as part of a drug treatment programme.

It can be difficult to tell your midwife or doctor about using drugs. However, it is very important to be honest.

They are there to help you have a safe and healthy pregnancy and will not judge you. They can help you understand the risks and support you to cut down or stop taking drugs.

Getting help

You can get help from:

• Your midwife
• Your GP
• Drug treatment services

These services will not judge you and can help you access a wide range of other services. This includes antenatal and family support.

Specialist support services are private and confidential. The staff are there to listen to you and help you without judgment. They understand how difficult it can be tp take those first steps.

If you are already being supported by a specialist drug support service, tell them that you are pregnant as soon as you know. You may be offered the service of a specialist midwife or doctor, who will talk you through your antenatal care step by step. They will discuss any extra appointments or scans that may be offered.

They will also discuss any extra support your baby may need when they are born. At these appointments, you should be able to talk about your feelings and worries.

Your healthcare team will work with you to support you to have as healthy a pregnancy as possible.

You can also contact FRANK for friendly, confidential drugs advice. This includes information on the different types of help available.

The FRANK helpline is open every day, 24 hours a day on 0300 123 6600. You can also text them on 82111.

What are replacement therapies?

If you are dependent on opioids like heroin, your doctor may suggest a replacement therapy. These therapies involve prescribing safer alternative medications, such as methadone or buprenorphine.

These medications help manage withdrawal symptoms and cravings, providing a stable dose that is safer for both you and your baby than illegal drug use. Replacement therapies are part of a comprehensive treatment plan designed to support you through pregnancy and beyond.

Caring for your baby after birth

Withdrawal symptoms in your baby

Some babies may experience withdrawal symptoms after birth. This is also known as Neonatal Abstinence Syndrome (NAS).

NAS symptoms can be mild, but are sometimes very serious. They can include sleep problems, irritability, feeding problems and tremors. More serious complications such as seizures, and breathing problems are not uncommon.

If you have used illegal drugs such as heroin or cannabis in the weeks before birth, your baby will likely need close regular monitoring and supportive treatment. This care may be required for a few days or weeks after birth to help them with any withdrawal symptoms.

It's very important to tell your doctor or midwife if you have been using drugs during pregnancy. This allows them to arrange for your baby to be born at a unit where the appropriate treatments can be available if needed and can then be started as soon as possible. Some of these babies may need specialist care and medical treatment to help them withdraw.

Breastfeeding

It is not safe to use illegal drugs while you are breastfeeding. They can affect your ability to look after your baby safely.

Illegal substances pass on to your baby through your breast milk. The long-term effects of taking illegal drugs while breastfeeding are still unknown.

If you are using illegal drugs, talk to your midwife, health visitor, or GP. They will not judge you and can help you access the services you need to reduce or stop using drugs. Experts advise that you stay away from CBD oil products during pregnancy and breastfeeding.

If you are looking for information on how illegal drugs can affect breastfeeding, you can contact the Drugs in Breastmilk Service. You can email them at druginformation@breastfeedingnetwork.org.uk or find them via their Facebook page, online chat or email. In an emergency, please contact 999 or seek urgent medical assistance.