Substance Misuse and Pregnancy Bristol Specialist Drug and Alcohol Service (BSDAS)

There are many myths and untruths about the effects of substance misuse in pregnancy. This leaflet will give you some basic information, but is designed as a starting point from which you can ask your drug worker or midwife for further information or support.

Tobacco and Cannabis

Babies born to mums who smoke are more likely to be of low birth weight and to develop asthma. There is also an increased risk of “cot death”.

Cannabis passes easily into breast milk and builds up in the baby, particularly the brain. This can change how the brain works, unsettling the baby, and may result in problems in later life. It is best not to smoke cannabis when breastfeeding and to avoid your baby being in contact with any type of smoke in the house as they grow up.

Our advice is to stop or to cut down as much as you can. If you feel you need some help, please ask your midwife to refer you to the stop smoking midwife, or ask your drug worker for advice.

Alcohol

Drinking alcohol during any stage of your pregnancy may affect the development of your baby’s brain. This is the case no matter how much or how often you drink.

Problems caused include low birth weight, learning difficulties and failure to thrive. Ideally, we recommend that you do not drink any alcohol at all while you are pregnant.

If you think you will find it difficult to stop, ask your drug worker or midwife about detox options.

Benzodiazepines (e.g Diazepam, Nitrazepam)

Using benzodiazepines while you are pregnant can cause severe withdrawal symptoms for your baby once born. Sometimes this will begin up to a couple of weeks after your baby is born, but may then last for several weeks and your baby may need medication to ease the symptoms.

However there are risks of abruptly stopping benzodiazepine use. Therefore, if you are using or being prescribed benzodiazepines, please talk to your drug worker who can help you with a plan to stabilise what you are using.

When you are ready, you can gradually reduce the dose. Also, please ask your midwife or the hospital doctor for advice if you are planning to breastfeed.

Stimulants (e.g. Cocaine, Amphetamine)

It is important to stop stimulant use while you are pregnant because stimulants can pass easily into the baby via the placenta.

Stimulant use has been found to increase the chances of miscarriage, premature birth and separation of the placenta. This may cause brain damage in the baby and even death of the baby and the mother.

After birth, babies may have withdrawal symptoms, be irritable and have feeding difficulties. It is safe to stop using stimulants during pregnancy at any time so we advise you to stop and we are here to help if you are finding it difficult.

Other Drugs

It is best to avoid any recreational drug use in pregnancy including ‘legal high’s, as little is known about the potentially harmful effects on the unborn baby.

However, if you are being prescribed any medication, it is important not to stop this until you get advice that it is safe to do so, from your doctor or midwife.

Opiates (e.g. Heroin, Methadone)

If you use heroin whilst you are pregnant, there is an increased risk that your baby will be of low birth weight or be born prematurely. Therefore, it is important to stabilise on an opiate substitute, such as methadone or buprenorphine. Opiates cross into the baby’s bloodstream via the placenta.

This means that any changes in your dose will also affect your baby, so it is important not to take too much and also to avoid experiencing withdrawal symptoms, as your baby will be withdrawing too. This could result in your baby not growing properly or being born prematurely.

It is still possible to reduce your methadone or buprenorphine during pregnancy, but you must do this carefully with advice from your drug worker.

As opiates cross into the baby’s bloodstream, your baby may experience withdrawal symptoms after delivery. For this reason you and your baby will stay in hospital for at least five days so that your baby can be observed and treated with medication if required.

Breast feeding

Breast milk gives babies all the nutrients they need for the first six months of life and helps protect them from infection and disease. It also reduces a mothers’ chances of getting certain diseases in later life, as well as being a great way of bonding with your baby. If you are using drugs or are on any prescribed medication and wish to breastfeed please ask your midwife, hospital doctor or BSDAS key worker for advice.

Getting support

It is crucial to tell your midwife of any substances you may be using. The earlier you approach any problem you may have, the better for the health of both you and your baby. This will give you the best chance of stabilising your drug use, getting reliable information and having a better experience.

Social Services will not automatically be called because you use drugs. They only get I involved if you need some extra help, or if there are concerns about your baby’s safety.