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Quick Facts

Drug Use During Pregnancy

By The Manual's Editorial Staff,

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More than half of pregnant women take medicines, drink alcohol, smoke, or use illegal drugs at some time during pregnancy.

  • Taking certain drugs and medicines while pregnant may hurt your baby or cause a miscarriage

  • In general, you should avoid medicines during pregnancy unless they're absolutely necessary

  • Talk to your doctor about which of your medicines, vitamins, and herbal supplements are necessary and which ones you shouldn’t take

  • Drinking alcohol during pregnancy is a major cause of birth defects

How do drugs affect pregnancy?

Many drugs taken by pregnant women are carried to the baby in the womb by crossing the placenta. The placenta is an organ on the inside of the uterus (womb) that carries blood with oxygen and nutrition to the baby. Drugs can:

  • Cause the baby's organs to grow abnormally, leading to birth defects or death

  • Affect the placenta so it doesn’t work properly

  • Cause the baby to be born too early

How do I know if a drug is safe to take during pregnancy?

Many medicines and vaccines (shots) aren't safe for pregnant women. They can cause birth defects, growth problems, or even death of a baby before or after birth.

On the other hand, there are some medicines and vaccines that are important to take during pregnancy. They prevent health problems that can harm you or your baby. You shouldn't just stop taking these medicines when you get pregnant. You may need to take medicine during pregnancy if you have a disease that can hurt you or your baby, such as:

Talk to your doctor about the medicines and drugs you take:

  • As soon as you know you're pregnant, tell your doctor

  • Ask your doctor about the risks and benefits of your prescription medicines so you can decide whether to stop them

  • Tell your doctor about any vitamins, supplements, and non-prescription (over-the-counter) medicine you take and ask about their risks

  • Be honest with your doctor about what social drugs and illegal drugs you use

Social drugs include tobacco, alcohol, caffeine, and marijuana (which is legal in some states). Illegal drugs include amphetamines, cocaine, and heroin, among others.

If a medicine you take is risky, doctors can often replace it with a safer medicine. And sometimes even a dangerous medicine is worth taking to treat an even more dangerous illness. For example, you may need to take a medicine called a blood thinner to prevent fatal blood clots. Your doctor will choose the right medicine to keep you and your baby healthy. Always talk with your doctor before stopping, starting, or changing your medicines.

Vaccines

During pregnancy and the first few months of life, your baby is protected against many infections from you (your immune system). This protection comes to your baby through your bloodstream during pregnancy. If you haven't had all your vaccinations, some are safe to get during pregnancy. However, some vaccines shouldn't be given and some are given only when you have a high risk of infection.

Your doctor will recommend 2 vaccines that are safe to give during your pregnancy:

  • During flu season, women more than 12 weeks pregnant should get a flu shot

  • Women who are between 27 and 36 weeks pregnant should get the Tdap vaccine (protects against tetanus, diphtheria and pertussis, which is whooping cough)

Vaccines that aren't safe during pregnancy include:

What problems do social drugs cause during pregnancy?

Social drugs that can cause problems include:

  • Alcohol

  • Caffeine

  • Cigarettes (tobacco)

  • Marijuana (legal in some states)

Alcohol

Alcohol is a leading cause of birth defects. It can cause:

  • Fetal alcohol syndrome

  • Miscarriage

  • Low birth weight

  • Behavior problems in childhood

Fetal alcohol syndrome is a set of problems that includes abnormal development of the baby's head and face, brain damage, low intelligence, stunted growth, and other problems. As few as 3 alcoholic drinks a day can cause fetal alcohol syndrome.

You shouldn't drink alcohol while pregnant.

Caffeine

Doctors are unclear if caffeine during pregnancy harms a baby. Caffeine is in coffee, some teas, some sodas, energy drinks, chocolate, and some drugs.

Doctors think that caffeine is safe in small amounts, such as one cup of coffee per day.

However, drinking more than 7 cups of coffee per day may cause:

  • Miscarriage or stillbirth

  • Premature birth (a baby that is born too early)

  • Low birth weight

Doctors suggest drinking very little caffeine during pregnancy. You can try decaffeinated drinks instead.

Cigarettes

If you smoke cigarettes when pregnant or even breathe in smoke from people who are smoking, it can hurt your baby. It may cause:

  • Low birth weight

  • Birth defects of a baby’s heart, brain, and face

  • Miscarriage

  • Premature birth (a baby that is born too early)

  • Problems with a child’s growth, behavior, and intelligence

You shouldn't smoke at all while pregnant and should avoid being around smoke as much as you can.

Marijuana

Doctors are unclear if marijuana during pregnancy harms a baby but suggest that you avoid it. Marijuana may cause behavior problems in your baby if you use it heavily while pregnant.

Aspartame

Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. For example, pregnant women should drink less than 1 liter (about 3 cans) of diet soda per day.

However, pregnant women with a disease called phenylketonuria shouldn't eat or drink aspartame.

What problems do illegal drugs cause during pregnancy?

Using illegal drugs during pregnancy can cause serious problems for a pregnant woman and her baby. All illegal drugs and some legal drugs (particularly opioids such as oxycodone), when used too much, increase the chances of a baby being too small or being born too early.

Injecting drugs also increases the chance of a pregnant woman giving her baby infections, such as hepatitis or HIV.

Illegal drugs that can cause problems include:

  • Amphetamines

  • Bath salts

  • Cocaine

  • Hallucinogens

  • Opioids

Amphetamines

Amphetamines during pregnancy may cause:

  • Birth defects, especially of the heart

  • Problems with a baby’s growth before birth

Bath salts

Bath salts is the name given to a group of drugs made from different chemicals that give the same high as amphetamines. Using bath salts during pregnancy may cause:

  • The baby not to get enough oxygen

  • Stillbirth (death of a baby before or during birth)

  • Placenta problems

  • Birth defects

Cocaine

Using cocaine during pregnancy can narrow blood vessels in the placenta, which can cause:

  • Miscarriage

  • Premature birth (a baby that is born too early)

  • Low birth weight

Women who use cocaine during pregnancy often do other things that can harm their babies, such as smoking, using other drugs, or getting poor medical care. Because of this, doctors aren't sure which problems are caused by the cocaine alone. Still, you shouldn't use cocaine at all while pregnant.

Hallucinogens

Hallucinogens include Ecstasy (MDMA), methamphetamine, and LSD. Using hallucinogens during pregnancy may cause:

  • Miscarriage

  • Premature birth (a baby that is born too early)

  • Withdrawal symptoms in a baby

Opioids

Opioids include medicines (such as oxycodone, methadone, and morphine) that doctors prescribe to relieve pain. Heroin is an illegal opioid that people become addicted to and isn't prescribed by doctors. Using any opioids for a long time during pregnancy may cause:

  • Withdrawal symptoms in a baby

  • Miscarriage

  • Premature birth (a baby that is born too early)

  • Low birth weight

If you have a severe, painful injury (such as a broken bone or a bad burn), it's probably safe for your doctor to prescribe an opioid for several days. Otherwise, you should avoid using opioids.

Resources In This Article

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • DESOXYN
  • DOLOPHINE
  • DURAMORPH PF, MS CONTIN
  • OXYCONTIN