Drug use during pregnancy

When you are pregnant, it is important that you watch what you put into your body. Using illegal drugs is not safe for the unborn baby or for the mother.

Studies have shown that using illegal drugs during pregnancy can result in miscarriage, low birth weight, premature laborplacental abruption, fetal death, and even maternal death.

The following information can help you understand these drugs and their harmful effects:


  • Common slang names: pot, weed, grass, and reefer
  • What happens when a pregnant woman smokes marijuana? Marijuana crosses the placenta to your baby. Marijuana, like cigarette smoke, contains toxins that keep your baby from getting the proper supply of oxygen that he or she needs to grow.
  • How can marijuana affect the baby? Studies of marijuana in pregnancy are inconclusive because many women who smoke marijuana also use tobacco and alcohol.  Smoking marijuana increases the levels of carbon monoxide and carbon dioxide in the blood, which reduces the oxygen supply to the baby. Smoking marijuana during pregnancy can increase the chance of miscarriage, low birth weight, premature births, developmental delays, and behavioral and learning problems.
  • What if I smoked marijuana before I knew I was pregnant? According to Dr. Richard S. Abram, author of Will it Hurt the Baby, “occasional use of marijuana during the first trimester is unlikely to cause birth defects.”  Once you are aware you are pregnant, you should stop smoking. Doing this will decrease the chance of harming your baby.


  • Common slang names: bump, toot, C, coke, crack, flake, snow, and candy
  • What happens when a pregnant woman consumes cocaine? Cocaine crosses the placenta and enters your baby’s circulation. The elimination of cocaine is slower in a fetus than in an adult. This means that cocaine remains in the baby’s body much longer than it does in your body.
  • How can cocaine affect my baby? According to the Organization of Teratology Information Services (OTIS), during the early months of pregnancy cocaine exposure may increase the risk of miscarriage. Later in pregnancy, cocaine use can cause placental abruption, which can lead to severe bleeding, preterm birth, and fetal death. OTIS also states that the risk of birth defects appears to be greater when the mother has used cocaine frequently during pregnancy. According to the American Congress of Obstetricians and Gynecology (ACOG), women who use cocaine during their pregnancy have a 25 % increased chance of premature labor. Babies born to mothers who use cocaine throughout their pregnancy may also have a smaller head and be growth restricted. Babies who are exposed to cocaine later in pregnancy may be born dependent and suffer from withdrawal symptoms such as tremors, sleeplessness, muscle spasms, and feeding difficulties. Some experts believe that learning difficulties may result as the child gets older. Defects of the genitals, kidneys, and brain are also possible.
  • What if I consumed cocaine before I knew I was pregnant? There have not been any conclusive studies done on single doses of cocaine during pregnancy. Birth defects and other side effects are usually a result of prolonged use, but because studies are inconclusive, it is best to avoid cocaine altogether. Cocaine is a very addictive drug and experimentation often leads to abuse of the drug.


  • Common slang names: horse, smack, junk, and H-stuff
  • What happens when a pregnant woman uses heroin? Heroin is a very addictive drug that crosses the placenta to the baby. Because this drug is so addictive, the unborn baby can become dependent on the drug.
  • How can heroin affect my baby? Using heroin during pregnancy increases the chance of premature birth, low birth weight, breathing difficulties, low blood sugar (hypoglycemia), bleeding within the brain (intracranial hemorrhage), and infant death. Babies can also be born addicted to heroin and can suffer from withdrawal symptoms. Withdrawal symptoms include irritability, convulsions, diarrhea, fever, sleep abnormalities, and joint stiffness. Mothers who inject narcotics are more susceptible to HIV, which can be passed to their unborn children.
  • What if I am addicted to heroin and I am pregnant? Treating an addiction to heroin can be complicated, especially when you are pregnant. Your healthcare provider may prescribe methadone as a form of treatment. It is best that you communicate with your healthcare provider so he or she can provide the best treatment for you and your baby.


  • What happens when a pregnant woman takes PCP and LSD? PCP and LSD are hallucinogens. Both PCP and LSD users can behave violently, which may harm the baby if the mother hurts herself.
  • How can PCP and LSD affect my baby? PCP use during pregnancy can lead to low birth weight, poor muscle control, brain damage, and withdrawal syndrome if used frequently. Withdrawal symptoms include lethargy, alternating with tremors. LSD can lead to birth defects if used frequently.
  • What if I experimented with LSD or PCP before I knew I was pregnant? No conclusive studies have been done on one-time use effects of these drugs on the fetus.  It is best not to experiment if you are trying to get pregnant or think you might be pregnant.


  • Common slang names: meth, speed, crystal, glass, and crank
  • What happens when a pregnant woman takes methamphetamine? Methamphetamine is chemically related to amphetamine, which causes the heart rate of the mother and baby to increase.
  • How can methamphetamine affect my baby: Taking methamphetamine during pregnancy can result in problems similar to those seen with the use of cocaine in pregnancy. The use of speed can cause the baby to get less oxygen, which can lead to low birth weight. Methamphetamine can also increase the likelihood of premature labor, miscarriage, and placental abruption. Babies can be born addicted to methamphetamine and suffer withdrawal symptoms that include tremors, sleeplessness, muscle spasms, and feeding difficulties. Some experts believe that learning difficulties may result as the child gets older.
  • What if I experimented with methamphetamine before I knew I was pregnant? There have not been any significant studies done on the effect of a one-time use of methamphetamine during pregnancy. It is best not to experiment if you are trying to get pregnant or think you might be pregnant.

What does the law say?

Currently, Tennessee is the only state that holds prenatal substance abuse as a criminal act of child abuse and neglect. That does not always stop prosecutors from trying to charge mothers with endangerment or neglect. Women are typically offered a choice between serving time in jail or joining a rehab program.

Many states have expanded their civil child-welfare requirements to include substance abuse during pregnancy as grounds for terminating parental rights in relation to child abuse and neglect.

The laws that address prenatal substance abuse are as follows:

  • Iowa, Kentucky, Louisiana, Minnesota, North Dakota, and Rhode Island’s healthcare providers are required to test for and report prenatal drug exposure. Indiana health care providers are only required to test.
  • Alaska, Arizona, Arkansas, California, District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Montana, Nevada, Ohio, Oklahoma, Pennsylvania, Utah, Virginia, and Wisconsin’s health care providers are required to report prenatal drug exposure. Reporting and testing can be evidence used in child welfare proceedings.
  • Some states consider prenatal substance abuse as part of their child welfare laws. Therefore, prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect. These states include Alabama, Arizona, Arkansas, Colorado, District of Columbia, Florida, Illinois, Indiana, Iowa, Louisiana, Maryland, Minnesota, Missouri, Nevada, North Dakota, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia, Washington, and Wisconsin.
    • Indiana’s laws only allow a healthcare provider to release drug use information with the woman’s consent.
    • Missouri’s laws state that testing positive for drugs within 8 hours post-delivery AND she has either a previous child abuse/neglect conviction or if she did not complete a recommended substance abuse treatment program, constitutes unfitness as a parent.
  • Some states have policies that enforce admission to an inpatient treatment program for pregnant women who use drugs.  These states include Minnesota, South Dakota, and Wisconsin.
  • In 2014, Tennessee made drug use during pregnancy a criminal offense.

How can I get help?

You can get help from counseling, support groups, and treatment programs. Popular groups include the 12 step program.

Numbers that can help you locate a treatment center include:

  • National Drug Help Hotline 1-800-662-4357
  • National Alcohol and Drug Dependence Hopeline 1-800-622-2255

Another Helpful Article:

Compiled using information from the following sources:

Organization of Teratology Information Services, https://otispregnancy.org/
Motherisk.org, https://www.motherisk.org/
American Council for Drug’s Education, https://www.acde.org/
March of Dimes, https://www.marchofdimes.org/
The Alan Guttmacher Institute, https://www.guttmacher.org/