Pregnancy can be both a beautiful and complicated time for women and their families. Health risks are increased, but the impending joy of having a child is near at hand. For women who struggle with substance abuse or addiction, though, this time in their life can be complicated by more than the average pregnancy concerns.
Pregnant women in need of substance abuse or addiction treatment may be afraid to reach out due to stigma, they may be unsure where to turn for help or be fearful of complications, risks or the uncertainty of what will happen to them or their baby during treatment.
Fortunately, there are now many drug and alcohol rehab programs in place for pregnant women, with a new one right here in Ohio at The Bluffs. Our program is tailored specifically to the needs of pregnant women and their unborn children, with components which address the unique needs of these women.
This program works to restore the health of the mother while maintaining the health of the fetus and to equip the woman with everything she needs to build and uphold a substance-free life.
Dangers Of Substance Abuse And Addiction During Pregnancy
Substance abuse and addiction pose risks to the average person on a far-ranging scale. Addiction affects every aspect of a person’s life, from health risks and complications to family troubles to legal issues to job loss or financial struggles. For a pregnant woman who is newly faced with the added concern of caring for an unborn child, these concerns are amplified.
Health risks alone are perhaps the greatest danger to pregnant women facing addiction. There is a high potential for adverse effects on fetal development when a pregnant woman abuses drugs or alcohol. While effects to fetal health will vary by the drug of abuse and other factors, some general negative effects which may occur include:
- behavioral problems after birth
- birth defects
- cognitive development issues after birth
- development of drug dependency in the baby
- low birth weight
- premature birth
- small head size
- sudden infant death syndrome (SIDS)
Many drugs of abuse increase the risks of adverse effects, and certain drugs of abuse carry risks of additional effects. Smoking during pregnancy, for example, can result in many of these effects as well as preterm birth, respiratory issues and slowed fetal growth.
A dangerous complication of substance abuse during pregnancy can result from abuse of some drugs, especially opioids, and is called neonatal abstinence syndrome (NAS). This syndrome occurs when a pregnant mother abuses drugs which cause dependence, particularly opioids and heroin, and the drugs pass through the placenta to the fetus, causing the child to become dependent.
After the baby is born, and no longer exposed to the effects of opioids, he or she is likely going to experience withdrawal symptoms as the drug is removed from their system, especially if the mother continuously abuses opioids throughout the pregnancy and in the week before birth. Neonatal abstinence syndrome can result in the baby having feeding troubles after birth, low birth weight, respiratory (breathing) troubles and seizures or even death.
Which Drugs Are Dangerous To Use During Pregnancy?
There is no standard of safe drug or alcohol use during pregnancy, even with prescription medications. Pregnant women in treatment should work closely with physicians and treatment specialists to ensure they are receiving safe doses of medications at all times.
The following substances may cause dangerous effects during or after pregnancy:
- opioid drugs and prescriptions
- prescription drugs
The effects of pregnancy may vary by the drug of abuse, the frequency of abuse, duration of abuse and if and how quickly a mother seeks treatment.
Specialized Care For Pregnant Women
Due to the unique needs of pregnant women during treatment—care for the mother’s physical, psychological and emotional health as well as the health of the unborn child—pregnant women in addiction treatment need specialized care.
Each woman who comes to addiction treatment will have different needs than the next, depending on her personal needs, the drug of abuse and the needs of her pregnancy. However, the National Institute on Drug Abuse names a few treatment components necessary for all specialized addiction treatment programs for pregnant women:
- evidence-based treatments
- medication when needed
- daily medical monitoring
While pregnant women do have unique needs in addiction treatment, a few tried-and-true methods can help pregnant women overcome addiction issues long-term. These include counseling, group and/or individual therapy and behavioral therapy.
Counseling allows the pregnant woman to work closely with a treatment specialist to establish recovery goals and to assess ongoing recovery progress, as well as work through certain issues which contribute to or led to substance abuse.
Group therapy helps connect pregnant women in treatment with others who are also in recovery. In The Bluffs’ treatment program, pregnant women will be connected to other women who are undergoing issues similar to their own, promoting a sense of community and support. Individual therapy allows pregnant women to work through struggles which may trigger substance use or lead to relapse and can help address past trauma, stressors and more which affect addiction.
Behavioral therapy, such as the cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) offered at The Bluffs, helps individuals work through destructive behavior and establish positive mindsets to incorporate new behavioral habits and thought processes.
Medication-Assisted Treatment (MAT)
Due to physical dependence, pregnant women may need medication-assisted treatment, especially those who are dependent on prescription opioids or heroin. Many people need medication to alleviate withdrawal symptoms during detoxification, but some also need ongoing medication management known as MAT.
Medication-assisted treatment combines medication management with evidence-based therapies and 24/7 medical support to aid in recovery and help avoid relapse. Pregnant women addicted to opioids may need to taper off the use of them, and MAT allows them to do so in a supported environment and within a timeline that is right for them.
There are no FDA-approved medications for addiction treatment of pregnant women. However, research has shown that certain medications, combined with comprehensive prenatal care and addiction treatment, can improve many of the adverse possible outcomes associated with untreated opioid abuse in pregnant women.
Such medications include buprenorphine (Suboxone, Subutex). The pregnant woman will likely receive one of these medications during detoxification, then continue to receive it during formal treatment.
Daily Medical Monitoring
Pregnant women will need not only daily monitoring but also constant access to medical support. Pregnant women, in general, must work in close confidence with physicians to ensure their own physical and psychological health and that of their unborn baby. But addicted pregnant women may also be facing other complications, such as the risk of relapse or treatment of additional substance use disorders or mental health disorders.
These added complications can make treatment for addicted pregnant women more difficult, which is why daily and constant monitoring is so important. In this way, pregnant women can receive medication in a timely manner as needed, have vital functions monitored, address any physical concerns like nutritional deficiencies and have a support system in place if any complications arise.
Pregnancy Risks And Complications During Treatment
In addition to the adverse effects of substance abuse to the health of the fetus and mother during pregnancy and birth, a child born to an addicted mother or who experienced dependency in the womb can see complications later in life. Some of these include behavioral problems and growth and developmental issues. Preterm labor, in particular, can increase the risk that a child will experience such issues, and many illicit drugs of abuse can result in preterm labor, including cocaine, heroin, prescription opioids, methamphetamine, and marijuana.
There is also a condition for certain people, whose mothers drank alcohol while pregnant with them, can develop called fetal alcohol spectrum disorders (FASD). According to the Centers for Disease Control and Prevention, the effects of these disorders will affect each person in a different way.
The following are possible symptoms of a fetal alcohol spectrum disorder:
- abnormal facial features (i.e. smooth ridge between the nose and upper lip)
- difficulty concentrating or paying attention
- difficulty in school, particularly in math
- heart, kidney or bone problems
- learning disabilities
- poor coordination or memory
- low body weight
- low IQ
- sleep troubles or sucking issues as a baby
- small head size
- shorter height
- vision troubles
Perhaps one of the greatest risks for drug and alcohol abuse during pregnancy is that substance abuse and addiction tend to result in a person neglecting their health or not seeking health care when they need it. For a pregnant woman, seeking prenatal care and having access to help at all times is crucial for the health of the mother and baby.
Medically Supervised Detox For Pregnant Women
Pregnant women who have become dependent on drugs will need to detoxify their bodies prior to treatment. For some, this process may require medication and will certainly require constant medical monitoring.
The drug and alcohol rehab program for pregnant women at The Bluffs incorporates medically supervised detox when needed. Pregnant women can enter the program and receive ongoing medical support, medication if necessary, such as buprenorphine (Suboxone), nutritional support and preparation for inpatient treatment which begins immediately after completing detox.
It’s important that pregnant women undergoing detoxification receive addiction treatment immediately following detoxification. Otherwise, they likely will be unable to remain substance-free.
Co-Occurring Disorder Treatment For Pregnant Women
Pregnant women in addiction treatment may come to treatment with other illnesses or conditions, which can include co-occurring disorders (also called a dual diagnosis). A pregnant woman who has a co-occurring disorder struggles with both addiction or substance abuse and a mental health disorder.
Treating co-occurring disorders can present additional complications, as identifying and properly addressing both disorders is key to recovery success. At The Bluffs, our treatment specialists will provide full clinical assessments for each client to determine all treatment needs and treat them accordingly.
If a pregnant woman needs medication, this decision will be made by her clinician and she can receive it daily from staff. Clinical assessments also help determine the best overall course of treatment, such as which therapies and other components to include. The goal of co-occurring disorder treatment for pregnant women is to help them learn to manage both disorders, change behavior for the better and achieve sobriety and learn to maintain it.
Other Treatment Components For Pregnant Women
Near the end of inpatient treatment, it’s important that pregnant women have a plan in place, both for continued care for their health and pregnancy and for recovery. Addiction often leads to relapse for those newly in recovery. Much of inpatient treatment helps individuals prepare the skills and tools necessary to confront relapse if and when it happens.
To combat relapse, pregnant women should have access to aftercare, such as community support groups and local addiction treatment resources. Outpatient services and programs typically provide counseling and group therapy for continued care. The Bluffs provides resources for pregnant women for continued care, offers access to an alumni network and reaches out to program graduates to aid in a lasting recovery.
Find Addiction Treatment For Pregnant Women
Pregnant women can experience any number of complications, risks and side effects due to substance abuse or addiction. That’s why it’s of utmost importance that pregnant women get into treatment as soon as possible—to give themselves and their unborn child the best chance at a lasting recovery. Learn more about the drug and alcohol rehab program for pregnant women in Ohio at The Bluffs today.
American Society on Addiction Medicine — Public Policy Statement on Women, Alcohol and Other Drugs, and Pregnancy
National Institute on Drug Abuse — Prenatal Effects, What are the unique needs of pregnant women with substance use disorders?
U.S. National Library of Medicine: National Institutes of Health — Treatment of Opioid-Dependent Pregnant Women: Clinical and Research Issues