Detox During Pregnancy

Making the Right Choice for Your Baby

Detox during pregnancy is vital for the health of the baby. Women are most likely to become addicted or abuse a substance when they are between the ages of 18 and 29 – the time they’re also most likely to get pregnant.​​​1 As a result, their babies are born with a history of exposure to illegal drugs, alcohol, or tobacco. This can cause not only withdrawals in the baby, but also birth defects and a higher risk of miscarriage and early delivery.

Pregnant women struggling with addiction often need support and education to help them get clean for their babies and themselves. This article will take a look at how doctors can help a woman detox during pregnancy for the sake of her health and her baby.

How Do Certain Substances Affect Pregnant Women?

Cocaine

Cocaine use during pregnancy is known to cause especially harmful side effects for the mom and baby. One example is placental abruption, a condition that can make a pregnant mom lose a lot of blood. Other side effects include:

  • Premature delivery
  • Low birthweight
  • A baby that is small for their gestational age

Some studies also say that cocaine use causes side effects like language and cognitive development problems.

Methamphetamines

Doctors have found the side effects of using meth during pregnancy are a lot like those for a person that uses cocaine. They include:

  • Low birthweight
  • Increased miscarriage risk
  • Higher risk for birth defects and developmental delays
  • Increased risks for high blood pressure in the mother

Moms who abuse methamphetamines in pregnancy are also at higher risk for pre-eclampsia. This is a condition that causes very high blood pressures that can possibly lead to seizures and death.

Opiates

Abusing pain pills can lead to a condition doctors call neonatal abstinence syndrome or NAS. This condition causes a baby to undergo withdrawals from opiates once it’s born. These withdrawal symptoms are hard to watch and can include:

  • Problems feeding
  • Poor muscle tone
  • Problems breathing
  • Seizures
  • Severe shaking

Doctors know NAS aslo increases the risks for infant death and causes a baby to require lots more healthcare at an earlier age. Babies with NAS are also at greater risk for growth problems and behavioral problems later on in life. If a woman smokes and uses pain pills, her baby is even more likely to develop complications.

Marijuana

A common misconception among pregnant women is that marijuana won’t hurt them or their unborn baby. However, marijuana and cannabis use has been shown to cause side effects such as:

  • Early labor
  • Increased risks for admission to the neonatal ICU
  • Increased risk for behavioral problems
  • Low birthweight
  • Poor academic achievement
  • Reduced growth in the baby's brain

The more marijuana a woman uses while she’s pregnant, the worse the effects usually are.

Benzodiazepines

Using benzodiazepines during pregnancy can increase the risk for cleft lip and palate in children, especially when a pregnant mom takes these medications in the first trimester.​​​2 According to the Massachusetts General Hospital Center for Women’s Health, the risks for cleft lip and palate is an estimated 0.7 percent.

Some reports have also revealed that newborns may have symptoms of benzodiazepine withdrawal after they’re born. These symptoms include decreased muscle tone, problems breathing, and sedation.

Withdrawal Complications

Sometimes it’s not so simple as just stopping a substance once pregnancy occurs. Detoxing from a substance can cause withdrawal symptoms that threaten a woman’s pregnancy and her health. That’s why a woman should see a doctor before she starts detoxing. A doctor can make recommendations as to how to stop quitting – things like making a plan for using less and less of a substance or prescribing medicines that can reduce the risks for side effects.

Alcohol Withdrawal

Alcohol withdrawals can cause a condition known as delirium tremens, where symptoms like tremors, hallucinations, high body temperatures, and seizures occur. While only a small percentage of people experience this syndrome, its occurrence puts the baby at risk.​​​ 3 As a result, most doctors recommend going through alcohol withdrawals in a hospital setting.

Cocaine Withdrawal

Currently, there aren’t medications a doctor can give to reduce the effects of cocaine detox. However, women may still wish to pursue inpatient detox for cocaine withdrawals because of the potential changes in blood pressure that can occur as a result of withdrawal from cocaine.

Opioid Withdrawal

Ideally, medications are administered to reduce the effects of opioid withdrawals. This can reduce the risks for overdose as well as provide a more controlled pathway that can lead to sobriety.

Benzodiazepine Withdrawal

Doctors usually recommend performing a slow taper of medications while pregnancy to reduce the risks for seizures and other complications that can occur.​​​4  However, it’s possible for some women to experience anxiety so significant that ending their medications during pregnancy may not be the best option. When this is the case, they should discuss the risks and benefits with their doctor to determine the safest plan to minimize risks whenever possible.

Overdosing While Pregnant and Naloxone

Naloxone or Narcan is a medication that blocks or reverses the effects of opioids. This medication is available via nasal spray or an injection. If a person suspects a pregnant mom is overdosing, they can give her Narcan, and this will reverse the effects of the opioids and ideally prevent overdose.

Many times if a pregnant mom struggles with opioid addiction, a doctor may prescribe Narcan to keep in her home or on her person to prevent an overdose whenever possible. According to the nonprofit organization MotherToBaby, studies don’t indicate that taking Narcan can cause birth defects. Doctors do know that if a woman needs Narcan for overdose, she may be at greater risk for early (pre-term) delivery.

Warning Signs and Statistics

Warning Signs To Watch For

Knowing the warning signs a woman may be having problems related to her pregnancy and substance abuse can be difficult if she doesn’t seek medical care. A doctor will regularly evaluate a woman and monitor her baby’s growth. Usually, a smaller-than-expected baby is one of the first signs that a woman’s substance abuse is affecting her pregnancy. Without a doctor monitoring this, it may be difficult for a woman to know.

It’s really important to seek regular medical care while pregnant, especially if there is the presence of a substance use disorder or a history of substance abuse.

Statistics

According to an article in the journal F1000 Research, the substance women most commonly abuse during pregnancy is tobacco. An estimated 15.9 percent of pregnant women smoke cigarettes. An estimated 8.5 percent of pregnant women drink alcohol, and 5.9 percent of all pregnant women use illicit drugs. Many women will use multiple substances while pregnant, including drugs and alcohol.

Women that Achieved Abstinence While Pregnant During Treatment
83%

According to a study published in the journal Drug and Alcohol Dependence, an estimated 83 percent of women who sought treatment for substance abuse while pregnant achieved abstinence.​​​5 Achieving sobriety for the better health of a woman’s unborn baby is possible. However, abuse of opioids is currently increasing among the pregnant population.

Detox Explained

Steps of Detox

The detox process usually involves the following steps:

Intake: A doctor will meet with the pregnant woman and discuss her substance abuse history. This includes the drugs or alcohol she uses, how long she’s used them, and how much she’s using a day. They’ll also discuss any other health concerns or overall concerns. 

Creating a Plan: A doctor will recommend a plan for detoxing from the substance. This may include quitting completely, going cold turkey, or slowly scaling back on the medicines, such as from benzodiazepines.

Getting Support: Detox begins and participation in counseling or other support services occur during the process.

Maintenance: Therapy isn’t over just because detox is over. Constant support helps to prevent relapse during pregnancy and beyond. Ongoing support can include therapy and participation in support groups.

What to Expect from Medical Detox

If opiate abuse occurs during pregnancy, a doctor may recommend medication-assisted treatment. This is taking methadone or buprenorphine while pregnant to reduce cravings for opioids. Research shows some pregnant moms are more likely to keep going with their prenatal care, and their babies are healthier if they use medications instead of taking opioids while pregnant. However, using medicines like methadone and buprenorphine do have a higher relapse rate for pregnant moms.

Research shows participation in MAT alongside therapy can improve long-term success in recovery from addiction.

Types of Detox Treatment Programs

Treatment programs may use different approaches to helping a woman detox when pregnant. They will often use talk therapies to help a woman understand how she can control her thoughts and actions, so she’s less likely to use during her pregnancy and beyond.

Doctors may use some of the following approaches for detox during pregnancy:

Cognitive Behavioral Therapy (CBT): This approach helps a woman identify how her old ways of thinking and behavior were keeping her addicted. She can then identify new behaviors that can reduce her risks for relapse.

Contingency Management: This approach involves providing rewards for good behaviors, such as a clean drug test or participation in support groups.

Motivational Interviewing: This approach involves talking with a woman to help her find her motivations for change. According to an article in F1000 Research, contingency management is one of the most successful approaches for pregnant women, especially for those who abuse cocaine and marijuana.

Drug Testing

In one small study of pregnant women struggling with substance abuse, an estimated 54.5 percent reported they avoided medical care altogether to avoid being caught using illegal drugs. Some women reported stopping use a few days before they knew they would be tested as a means to seek care.

Drug testing during pregnancy is one way to help a woman stay clean, but it isn’t the only way. Women who are pregnant also shouldn’t stop seeking medical care because they’re afraid of drug tests.

Pregnant Women that Avoided Medical Care to Avoid being Caught Using Drugs
54.5%

Finding Treatment

While there are lots of drug treatment centers in the United States, not all of them are familiar with the unique needs of a pregnant woman in detox. Because there are risks to two humans, not just one, the stakes are a lot higher. As a result, it’s usually better to seek treatment at a program that specializes in or is familiar with treating pregnant women who struggle with addiction.

If a woman isn’t sure where to start, she can call the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline at 1-800-662-HELP (4357). This hotline is free and operates 24 hours a day, seven days a week to help connect people with needed services in their area.

Detoxing While Pregnant Works With Medical Supervision

A high percentage of pregnant women who are addicted to drugs or alcohol don’t seek professional care out of fear they may be judged or even punished because of their addiction. However, the courts and public justice systems are more likely to look favorably on a woman that seeks help for her problems than a woman who continues to struggle and harms her baby.

Don’t be afraid to seek help, as there is never a wrong time to start recovery from drug and/or alcohol abuse. With time and treatment, a healthy baby can be delivered and life can move forward free from substances.