As a mother of 3 adopted children who were all exposed to drugs at some point in their lives, I’ve seen the challenging effects of maternal substance abuse at each developmental stage. My oldest daughter was born addicted to cocaine, along with many other issues. My youngest son was born addicted to methamphetamine, widely known as meth. My oldest son’s first years of life were significantly affected by meth exposure in utero and living in a home with a meth lab.

The effects of substance abuse during pregnancy are quite complicated, but I’ll break them down to better understand the impact. In this article, I shall highlight the types of substances pregnant women use, the immediate and long-term consequences of using drugs while pregnant, the challenges of self-reporting statistics, and what these facts and statistics look like from a personal perspective.

Drug use during pregnancy

There are many substances which doctors don’t recommend using while pregnant, and these may include some over-the-counter (OTC) drugs, prescription drugs, illicit drugs, alcohol, and tobacco. Numerous studies have been conducted on the impact each of these substances has on the fetus.

Although you can consume alcohol and tobacco if you’re of legal age, there’s a consensus that these substances can cause drug-related birth defects if taken by pregnant women. Just a little Advil or Vicodin for your pain problems? Not while you’re pregnant. Ibuprofen, Aspirin, and other common pain and cold relievers are also frowned upon in the 1st trimester’s early stages due to evidence of birth defects from prescription drugs and risk of stillbirths.

Natural remedies are often recommended to relieve any discomfort. But what if the mother is addicted to a stronger prescription or illegal drug? Mothers on drugs often give birth to “drug babies.”

Pregnancy and drug use: The facts

How many women use substances during pregnancy? The prevalence of drug use during pregnancy is difficult to quantify. The absence of specific guidelines for drug screening in pregnancy combined with unreliable self-reporting associated with stigma and the fear of consequences of using drugs while pregnant makes the actual numbers of affected births unknown. Here’s what we know;

• According to the Substance Abuse and Mental Health Services Administration, approximately 5% of women will admit to taking illicit drugs while pregnant.
• Generally, the reported statistics are heartbreaking. Recent data suggest that nearly 25 million Americans aged 12 or older are current illicit drug users. The numbers have gone up for adolescent girls who are now more likely than boys in their age group to be current non-medical users of psychoactive drugs.
• There are also concerns over prescribed opioid use among pregnant women, with 6.6% of reported cases admitting use while 21.2% of them conveying misuse by either obtaining it from a source other than a healthcare provider or using it for reasons other than pain.
• The growing stigma that people of color are the ones who do drugs while pregnant is discriminatory since substance abuse during pregnancy isn’t limited to one particular group. Data shows that this drug problem cuts across all racial and socioeconomic lines worldwide. Minorities from low-income areas are more likely to use illegal drugs with tobacco, marijuana, and alcohol, while more affluent women abuse prescription opioids combined with alcohol.
• What’s common for all these women is that they often live with a partner addicted to drugs. These women are also less likely to seek prenatal care to support their health or their baby’s.

Crossing the placenta to the fetus

How do the drugs get from the mother to the fetus? Drugs, alcohol, and other damaging substances can cross the placenta. The placenta is an organ that develops in your uterus during pregnancy connecting you to the fetus through the umbilical cord. Its job is to provide oxygen and nutrients to your growing baby and remove waste products from your baby’s blood.

What happens if the placenta is transferring substances such as meth, alcohol, cocaine, and marijuana? The placenta begins to constrict and blocks healthy nutrients and vitamins. However, substances such as alcohol and meth transfer easily due to their low molecular weight. Alcohol in particular crosses in very high concentrations. These substances begin to wreak havoc on the mother and growing fetus.

What happens once the substances have transferred to the fetus? When pregnant, there’s always something unique occurring in the development of the embryo and fetus each week. When the substances cross the placenta, they can easily alter fetal development. Drugs can cause congenital disabilities during the 3rd and 8th week of an embryo’s life and affect fetal organs and tissue’s normal growth and development as from the 9th week.

Most pregnant women use these substances in combination, so it’s often challenging to study each of the substances’ real impact. For example, a mother who uses meth may also drink alcohol, smoke cigarettes, and use marijuana.

Effects of substance exposure in utero

Here’s what scientists discovered about substances used while pregnant and the effect of their exposure;

1. Alcohol: The common birth defects resulting from alcohol abuse during the 1st trimester include your baby having unusual facial features such as a large forehead, a small head size compared to the body, shorter than average height, and low body weight. If you continue to drink alcohol, it might affect their brain and central nervous system. Once your child is born, he may develop physical, behavioral and learning problems referred to as fetal alcohol spectrum disorders (FASD), with fetal alcohol syndrome (FAS) as the most involved end of the spectrum.

2. Opiates: Opiates transfer through the placenta to the growing fetus and expose it to drugs (such as heroin, codeine, oxycodone) for a while, making it dependant on the drugs, which may eventually cause neonatal abstinence syndrome (NAS). Here your baby experiences withdrawals after birth when the drug slowly clears from the system. When they’re still in the womb, legal and illegal opiates affect the actual brain size. Meth reduces white matter in the brain in similar areas as seen in Parkinson’s Disease, resulting in low attention span and verbal memory challenges.

3. Marijuana: Many pregnant women see marijuana as harmless. However, research shows that using any form of marijuana increases the risk of having a miscarriage, leads to a higher infant mortality rate, and reduces the formation of healthy red blood cells. Drug-related birth defects from marijuana result from THC (the main psychoactive component of marijuana) restricting blood flow from the mother to the fetus. The half-life of THC is 8 days and can still be transferred to the developing fetus’ brain.

Consequences of maternal substance abuse to the child

My daughter

Let’s talk about cocaine. The challenge here is that you can’t just pick out one drug and say this is primarily why my 29 years old daughter has dealt with developmental challenges all her life. It’s not only one drug that has had an impact on who she is today. The challenge of nature versus nurture adds another dimension to it, especially since the birth mother is an addict.

My daughter was born addicted to cocaine with alcohol, tobacco, and syphilis in her system. She stayed in the hospital for a month for nurses and doctors to manage her condition. She was the 9th child out of 10 (that we know of) who was taken away at birth because her birth mother was a substance abuse addict and allegedly a sex worker.

Twenty years ago, when only FAS was known, my little girl was referred to as a “coke baby.” While she was premature and lagged in growth, these symptoms were associated with being addicted to cocaine. Today, some of her developmental challenges would place her under FASD. It’s not easy to tell what substance caused which damage.

There’s also the environmental factor. She never got the chance to bond with her birth mother or any specific individual for the first 30 days of her life. This loss is significant in the emotional and physical growth of an infant. She needed to get tested again for syphilis once she became a teenager to confirm whether the medication did its job because one may still test positive even though she got cured of the disease. Such factors put a strain on her overall well-being.

She still has trouble sounding out words, spelling, and some cognitive processing abilities, which are all symptoms seen in fetal alcohol syndrome in adults. However, they could also be the result of other substances her birth mother was using at the time. She’s still tiny in size and a little self-conscious of her large forehead, but she’s a beautiful grown woman who now teaches young children as an early childhood educator.

My oldest son

My oldest son was not born addicted to any drugs, but during the first few years of his life when he was in and out of foster care, his birth mother and father ran a meth lab in their home. He spent 12 years living in and out of foster care, was homeless for some time, and took care of his mother and sister at a young age.

His caseworker felt strongly that his brain development, while he was an infant, was impacted by breathing the chemicals of the meth lab. His cognitive processing abilities are slightly delayed. With no consistent adults in his life, his oppositional defiant disorder might have resulted from the combination of all these environmental factors.

My youngest son

My 2 boys share the same birth mother. They have 3 sisters; 2 younger and 1 in between them. My youngest son was born addicted to meth and with alcohol in his system. He also stayed in the hospital for over a month to manage the addiction and low birth weight. It has taken him 6 years to reach the average height and weight for his age, and now he’s physically on track with his age group. However his developmental and behavioral challenges remain unresolved.

When he first came home, my little guy had a hole in his heart. Thankfully by the time he turned 3, the gap had closed, and he currently has no congenital cardiac defects. He has severe ADHD with 3 doctors, a behavioral therapist, a psychologist, and an occupational therapist working to find the right tools for him to succeed.

Meanwhile, his disregard for rules and authority has gotten him suspended from school. He occasionally steals, opens up his bedroom window to flee, unbuckles himself in the car, jumps over me, and throws a toy car into the park while I’m driving. There are holes on the walls due to him hurling his baseball helmet, blocks, and other toys at me.

People always ask, “Have you tried this…have you tried that?” Yes, I have. I’ve tried everything the doctors and therapists suggest and more. Some nights he cries in my arms telling me he can’t turn his brain off to go to sleep. We struggle to sleep and stay up until 3 am.

Research shows that all these are outcomes most likely from prenatal exposure to meth. Every morning we start afresh with our special routine handshake and try to end the day reading books, singing songs, and cuddling. Sometimes it works and sometimes it doesn’t.

The 2 younger sisters were also born addicted to meth, taken away at birth, and eventually adopted by another family. Their delays are more severe because their birth mother’s addiction had worsened, with heroin added to her list. One of the girls had delayed gross motor skills that affected her ability to learn to walk. She has since improved, but the exposure to meth and heroin has significantly affected her development mentally and physically.

Prenatal drug use laws

Is substance abuse a crime? It depends if you ask me. Alabama, South Carolina, and Tennessee all have specific laws or interpreted laws stating that substance abuse during pregnancy is a crime. However, many states view substance abuse affecting the health of your newborn as child abuse.

In the United States, if healthcare workers suspect that your child has been exposed to illicit drugs, they can test him, but they’re not allowed to test you due to existing privacy rights unless you’re willing to be tested. If your infant tests positive, a representative from child protective services (CPS) steps in to remove your child from your care and into foster care.

If you’re not able to become sober after various interventions over time (it can go on for years), your child becomes available for adoption and that’s where people like myself come in. It’s not a great system, especially since children suffer physically, emotionally, and cognitively.

Addiction impacts everyone forever

The impact of prenatal exposure and addiction to drugs can last for a lifetime. Will my daughter always ask herself why she wasn’t good enough for her mother to give up cocaine? Will my oldest son often wonder what he could’ve done to save his mother when he was 5 years old? Or why he couldn’t be strong enough to keep his family together?

Addiction is agonizing for the individual and their families. It’s also harrowing for those who come along to care for the children left behind. These kids have been discarded by a system clueless about how to manage them. It’s a system filled with broken children, adults, and processes that hardly solve the issue of addiction or prenatal exposure to drugs.

The other day my daughter told me she found her birth mother on Facebook. The mother also has a tiny frame and a similar forehead. We were surprised that she’s still alive. We’ve both gone through the forgiving process, so there was no residual anger, just grief over the loss of everything. My daughter explained that she had no intentions of meeting the frail and possibly sober woman in the picture. I’m ok with that right now, and I’ll be with her if she ever changes her mind.