Alcohol and Illicit Drug Abuse in Pregnancy
Alcohol and Illicit Drug Abuse in Pregnancy Amy Luman COM/220 February 10, 2010 Philip Fasso When a woman becomes pregnant, it is vital to her baby's health that she leads a healthy life. This includes eating plenty of nourishing food, fulfilling an adequate amount of rest, and exercising regularly. For a pregnant woman, pregnancy substance abuse is twice as dangerous. First, drugs may harm her own health, which interferes with her ability to support the pregnancy. Second, some drugs can directly impair prenatal development. During pregnancy, virtually all illegal drugs pose a danger. Even legal substances, such as alcohol, tobacco, and prescription drugs are dangerous to expecting women. As many as one in 10 babies may be born to women who use illegal and prescription drugs during their pregnancies. While some prescription drugs may be necessary during pregnancy, alcohol consumption and illicit drug abuse is frightfully dangerous during pregnancy, and therefore pregnant women should value their value their babies and never misuse them. Healthy Lifestyle Pregnancy should be taken seriously and one should implement a healthy lifestyle to keep them and their unborn child safe. A pregnant woman’s lifestyle habits as well as her partner’s can gravely affect the health of their unborn baby. If the couple has already taken these precautions into action, it is encouraged and should be continued throughout the entire pregnancy. It is never too late for a pregnant woman to start thinking about making behavior changes, which in turn are good for her unborn child. Staying active during pregnancy is one stride closer to bearing a healthy child. Being active during pregnancy can have only positive effects on the expecting mother, with her feeling better and developing more energy. Physical activity can also help maintain muscle tone and strength for labor and birth. A great deal of benefits can come to a woman and her unborn by lightly exercising on a selected number of days a week. There are many types of physical activity and exercise, ranging from mild stretching to aerobic exercise. If an expecting mother is already involved in daily physical activities, there is no need for her to stop. If not, it is a good time for her to start doing something on a regular basis. Daily activities like walking up stairs, cleaning the house, and gardening are also good ways to keep active (Childbirth Connection, 2010). Making exercise an essential part of the day will in the end, only make a happy ending for both mother and her unborn. Being a healthy body weight is important before pregnancy. So eating a well balanced diet throughout pregnancy is very important to the health of oneself and child. Almost all pregnant women need to increase their intake of protein, certain vitamins and minerals such as folic acid and iron, and calories (for energy). Women who eat well and avoid known risks tend to have fewer complications during pregnancy and labor and are more likely to deliver larger, healthier babies. Eating a well-balanced diet, high in nutrients, is one of the most important things a woman can do to ensure the future health of both her and her baby (Isenberg, 2000-2009). Fetuses born to mothers who have unhealthy diets may be premature or have other problems at birth. In addition, recent research indicates that what a mother eats during the early months of pregnancy may determine her unborn child’s predisposition to certain diseases, such as diabetes and cancer. Eating a balanced diet during pregnancy can help to protect the health of both mother and baby. During pregnancy, a woman needs more of some nutrients, such as iron, calcium, and folic acid. For this reason, it is wise to start taking a multivitamin before pregnancy. Vitamins should be an essential part of every mother’s diet and daily routine when expecting. Prescribed multivitamins by one’s health care provider are very important to give the proper nutrients and prenatal care that an unborn child or fetus needs. It is proven that multivitamins, taken before one conceives, have a positive effect on the fetus’s chances of having birth defects. Although many drugs can potentially harm a pregnant woman’s fetus, some drugs are necessary for the wellbeing of both the woman and her fetus. Before making the decision to take any drug, whether it is prescription, over-the-counter, or a medicinal herb, a woman should always discuss both the hazards and advantages of the drug with her doctor to ensure the safety of both her and the fetus. A practitioner may suggest that a woman take certain vitamins and minerals during pregnancy (Merck Sharp & Dohme Corporation, 2009). Alcohol Any type of alcoholic beverage can have many hazardous effects on the developing fetus. Consuming alcohol during pregnancy can cause a wide-range of physical and mental birth defects. When a pregnant woman drinks, alcohol passes through the placenta to her fetus. In the fetus’s immature body, alcohol is broken down much more slowly than in an adult's body. As a result, the alcohol level of the baby's blood can be higher and remain elevated longer than the level in the mother's blood. This sometimes causes the baby to suffer lifelong damage. Recent government surveys indicate that about 1 in 12 pregnant women drink during pregnancy and about 1 in 30 pregnant women report binge drinking” (March of Dimes Foundation, 2010, p. 3). FAS or otherwise known as feta alcohol syndrome is a dangerous condition that occurs when a fetus has been exposed to excessive amounts of alcohol prenatally. One of the most common defects is facial abnormalities, although other defects may have greater consequences on the individual's health. These defects occur as a result of exposure to alcohol while in the uterus. An estimated one in 500 to one in 2,000 babies are born with FAS (Ladue, 2001). The common facial abnormalities of FAS include: short eye-slit fissures; a long, smooth upper lip groove; and a thin upper lip. The following picture represents a small child with these facial abnormalities. [pic] Other common physical problems include heart malformations and defects; a hollow at the lower part of the chest; permanent curving of one or more fingers; fusion of bones at the elbow; scoliosis; kidney malformations; and cleft lip and palate (abnormal openings in the lips or roof of the mouth). FAS affects children's height, weight, and head circumference. Many children with FAS are short and thin prior to puberty. As girls enter puberty, they remain short, but frequently gain weight and appear plump. Boys seem to remain fairly short and slender. So far, there has been no cure identified for FAS, but several treatment models are available. For the reason that CNS damage, symptoms, secondary disabilities, and requirements differ extensively there is no one treatment that works for everyone (Wikipedia, 2009). Although many women are aware that heavy drinking during pregnancy can cause birth defects, many do not realize that moderate or even light drinking also may harm the fetus. In fact, no level of alcohol use during pregnancy is safe. Therefore, pregnant women should by no means drink any alcohol, including beer, wine, wine coolers and liquor, throughout their pregnancy and while nursing. Also because women often do not know they are pregnant for a few months, women who may be pregnant or those who are attempting to become pregnant should not drink alcohol. Illicit Drug Use It should be obvious that Illicit and other prescription drugs are extremely harmful to the developing fetus, but disappointingly substance abuse continues to be a problem worldwide and drug abuse in pregnancy is no longer uncommon. Nearly four percent of pregnant women in the United States use illicit drugs such as marijuana, cocaine, ecstasy, and other amphetamines, and heroin and virtually 90% of women who abuse drugs are of childbearing age and consequently substance abuse in pregnancy is increasing (Ludlow, Christmas, Paech, & Orr, 2007). These and other illicit drugs may cause various risks for pregnant women and their babies. Some of these drugs can cause a baby to be born too small or too soon, or to have withdrawal symptoms, birth defects, or learning and behavioral problems. Tolerance and addiction to drugs and alcohol in pregnancy creates many potential problems for the mother, her fetus, and the obstetricians, anesthetists, pain specialists, drug, and alcohol specialists and neonatologists involved in her care. Pregnant women who use these drugs may also engage in other unhealthy behaviors that place their pregnancy at risks. Women who use heroin during pregnancy greatly increase their risks of serious pregnancy complications. These risks include poor fetal growth, premature rupture of the membranes (the bag of waters that holds the fetus breaks too soon), premature birth and stillbirth. As many as half of all babies of heroin users are born with low birth weight, use of heroin in pregnancy may increase the risk of a variety of birth defects. Most babies of heroin users show withdrawal symptoms during the first three days after birth, including fever, sneezing, trembling, irritability, diarrhea, vomiting, continual crying, and seizures. While heroin is usually sniffed, snorted or smoked, most users inject the drug into a muscle or vein. Pregnant women who share needles are at risk of contracting HIV and the hepatitis C virus. Such infections are capable of being passed on to the infant during pregnancy or at birth. Between 20 and 40 million Americans have used cocaine and five to six million are regular users. One million women of child-bearing age use cocaine (Blatt, Meguid, & Church, 2000). Cocaine use during pregnancy can affect a pregnant woman and her baby in many ways. During the early months of pregnancy, cocaine may increase the risk of miscarriage. Later in pregnancy, it may trigger preterm labor or cause the baby to grow poorly. As a result, cocaine-exposed babies are more likely than unexposed babies to be born prematurely and with low birth weight. Premature and low-birth weight babies are at increased risk of health problems during the newborn period, lasting disabilities such as mental retardation and cerebral palsy, and even death. Cocaine-exposed babies also tend to have smaller heads, which generally reflect smaller brains and an increased risk of learning problems. Cocaine use during pregnancy can cause placental problems, including placental abruption. In this condition, the placenta pulls away from the wall of the uterus before labor begins. This will lead to heavy bleeding that can be life threatening for both mother and baby. The baby may be deprived of oxygen and adequate blood flow when an abruption occurs. Prompt cesarean delivery, however; can prevent most deaths but may not prevent serious complications for the baby caused by lack of oxygen (March of Dimes Foundation, 2010). After birth, babies regularly exposed to cocaine before birth may have mild behavioral disturbances. As newborns, some are jittery and irritable, and they may startle and cry at the gentlest touch or sound. These babies may be difficult to comfort and may be withdrawn or unresponsive. Other cocaine-exposed babies “turn off” surrounding stimuli by going into a deep sleep for most of the day. Cocaine-exposed babies may be more likely than unexposed babies to die of SIDS. Avoidance Virtually all illegal drugs, such as heroin and cocaine, pose dangers to a pregnant woman. Legal substances, such as alcohol and tobacco, are also dangerous, and even medical drugs, both prescription and over-the-counter, can be harmful. For her own health and the health of her baby-to-be, a woman should avoid drugs and alcohol as much as possible; from the time she first plans to become pregnant or learns that she is pregnant. Alcohol is one of the most dangerous drugs for pregnant women, especially in the early weeks. In the mother’s body, alcohol breaks down chemically to a cell damaging compound that is absorbed by the fetus. Heavy drinking during early pregnancy greatly increases the risk of a cluster of birth defects known as fetal alcohol syndrome. This cluster includes a small skull, abnormal facial features, and heart defects, often accompanied by impeded growth and mental retardation. Heavy drinking in later pregnancy may also impede growth (American Council for Drug Education, 1999). It is not known whether light to moderate drinking can produce these effects. However, even if the risk is low, the stakes are very high. Medical experts agree that a woman should avoid alcohol entirely when she decides to become pregnant, or at least when the first signs of pregnancy appear. Even such mild beverages as beer and wine coolers should be off limits. The Law Currently there is only one state, South Carolina that holds prenatal substance abuse as a criminal act of child abuse and neglect. Other states have laws that merely address prenatal substance abuse. Some of these states consider prenatal substance abuse as part of their child welfare laws. Therefore, prenatal drug exposure can provide foundation for terminating parental rights because of child abuse. Of these states include: Colorado, Florida, Illinois, Indiana, Maryland, Minnesota, Nevada, Ohio, Rhode Island, South Carolina, South Dakota, Texas, Virginia, and Wisconsin. A number of states have policies that implement admission to an inpatient treatment program for pregnant women who use drugs. These states consist of: Minnesota, South Dakota, and Wisconsin. In 2004, Texas made it a felony to smoke marijuana while pregnant, resulting in a prison sentence of 2-20 years (American Pregnancy Association, 2000-2010). Unfortunately, it is not uncommon for a pregnant woman to become addicted to prescription medications and other illegal drugs. A mother who uses drugs during pregnancy risks her life and her baby’s life. Studies have shown that consumption of illegal drugs during pregnancy can result in miscarriage, low birth-weight, premature labor, placental abruption, fetal death, or even maternal death. While some prescription drugs may be necessary during pregnancy, alcohol consumption and illicit drug abuse is frightfully dangerous during pregnancy, therefore; pregnant women should value their babies and never misuse them.