Substance use in pregnancy is not uncommon. Drinking alcohol or taking illegal drugs during pregnancy can cause serious problems in your baby. Women should stop drinking alcohol and taking any illegal drugs before they try to get pregnant. This is important because:

• Even small amounts of alcohol or illegal drugs can be harmful to a pregnancy.
• Women do not always know they are pregnant for the first few weeks of their pregnancy.

Please speak with your doctor if you are concerned about this. There are many options for helping yourself and your baby. If abstinence is not possible, there are harm reduction options. For example, methadone maintenance treatment should be standard of care for opioid-dependent women during pregnancy. Other slow-release opioid preparations may be considered if methadone is not available.

Stopping some drugs abruptly can also cause problems with your baby so please seek medical advice before doing so.

What problems can happen if I drink alcohol during pregnancy? — Babies of mothers who drink alcohol during pregnancy can have fetal alcohol syndrome (also called “FAS”). This condition causes brain damage and growth problems. Compared with normal babies, babies with FAS tend to weigh less, have smaller heads, and be very fussy. When they grow up, they have life-long problems in how they think and act.

Drinking alcohol during pregnancy can also make women more likely to have a “stillbirth.” A stillbirth is when a baby dies before it is born, in the second half of pregnancy (after 20 weeks).

What problems can happen if I take illegal drugs during pregnancy? — That depends on which illegal drug you take, when you take it, how much of it you take, and for how long. Not every woman who uses an illegal drug during pregnancy has extra problems. But many women—and their babies—do.

The problems can also depend on other things, such as whether the mother smokes or drinks alcohol while taking illegal drugs.

What should I do if I am pregnant and already use alcohol or illegal drugs? — If you are pregnant and drink alcohol or use illegal drugs, speak to your doctor. He or she can give you advice on the best and safest way to quit.

Neonates of opiate-dependent mothers exposed to heroin, prescription opioids, methadone, or buprenorphine during pregnancy are monitored closely for symptoms and signs of neonatal withdrawal (neonatal abstinence syndrome).

The risks and benefits of breastfeeding should be weighed on an individual basis because methadone maintenance therapy is not a contraindication to breastfeeding