Pregnancy and addiction are two things that, in a perfect world, should stay far, far away from each other. But we don’t live in a perfect world; we live in the real one, which means that tragedy often goes hand-in-hand with majesty.
Amanda Hensley, 25, began abusing prescription painkillers as a teenager. And according to NPR, when she realized she was pregnant, she couldn’t stop. Hensley, who lives in Cleveland, said “Either I was puking from morning sickness or I was puking from being high. That’s kind of how I was able to hide it for a while.”
According to Nature, a baby was born dependent on opioids every 25 minutes in 2012 (the most recent year for which data are available). And according to the American Congress of Obstetricians and Gynecologists, pregnant women should have medically assisted therapy that should – at the very least – temporarily replace the dangerous opioids they are using with drugs that are more stable, such as methadone. Withdrawal during pregnancy shouldn’t occur if medically assisted therapy is available. And making things worse: quitting opioids cold turkey can be lethal to the baby and may increase the risk of preterm labor or fetal death.
Dr. Stephen Patrick, a neonatologist at Vanderbilt University’s School of Medicine, suggests that the medical community needs to do better when providing access to medically assisted care for substance abuse. Dr. Patrick says “I think it’s time for us to reshape how we view addiction in the United States,” he says. “It is a medical condition — it is not a moral failing.”
According to the National Institute on Drug Abuse, the effects of drug abuse on babies can be severe. It claims that drinking during pregnancy can lead to a child developing fetal alcohol spectrum disorders – which are characterized by low birth weight – as well as enduring cognitive and behavioral problems. Prenatal use of certain drugs, including opioids, may cause withdrawal syndromes in some newborns which are called neonatal abstinence syndrome (NAS). Babies with NAS are at far greater risk of seizures, as well as respiratory problems, some feeding difficulties, a low birth weight, and even death.
A 2010 report listed at the US National Library of Medicine/National Institutes of Health states that substance abuse during pregnancy has surged over the past thirty years in the United States, resulting in around 225,000 infants yearly who have prenatal exposure to illicit substances.
They suggest that regular screening along with the education of women of childbearing age remain the most important ways to reduce addiction in pregnancy. But some of their facts are sobering, including:
If you use cocaine while pregnant, you’re looking at the potential for spontaneous abortion, preterm births, placental abruption, and congenital anomalies. Other neonatal issues can include poor feeding, tiredness, and seizures. Moms using cocaine will require specialized prenatal care and the neonate may require extra supportive care.
Over half of women in their reproductive years use alcohol. Alcohol is a teratogen and its effects can include spontaneous abortion, growth restriction, birth defects, and mental retardation. Fetal alcohol spectrum disorder can have long-term effects on the infant.
Marijuana use, while not as bad as cocaine, can still lead to fetal growth restriction, as well as withdrawal symptoms in the neonate.
Use of amphetamines may lead to both congenital anomalies and other poor obstetric outcomes.
Many pregnant women feel stigmatized and won’t speak up for fear of embarrassment and shame. Writing for Rewire News, Kari Ann Rinker says “At 26 my addictions and my irresponsible, reckless, impulsive behaviors were catching up with me. When you’re fortunate if you remember to eat one meal a day, it’s also easy to forget to renew your birth control prescription.”
So what did she do? Her first prenatal visit confirmed her worst fears. She shared her drug history with her doctor as well as the news that the baby itself was conceived while using methamphetamines. Unfortunately, the bond of trust Rinker thought she was forming with the Doctor wasn’t to be.
Fortunately, despite her initial concerns, she considers herself lucky. Said Rinker, “I shared my negative experience with a friend who referred me to another doctor. I gave the honesty approach another try and shared my story with the new physician. The doctor’s reaction was one of compassionate understanding, lacking in the judgment and hatred that had greeted me prior.”
There’s a happy ending to this particular story: Rinker maintained her pregnancy while in recovery, pushing herself through the face of stigmatization and now has a healthy, happy teenager.
Not everyone is as strong as Rinker. Finding a confidant helps anyone who’s in recovery or looking to enter into it. They can be a member of the clergy, a friend who’s already in recovery, or a family member.
If you’re pregnant, you’re no longer just responsible for your own life; you have another precious soul inside you who, now more than any other time in their life, needs you sober.