PREGNANCY: WHAT SHOULD I DO AND NOT DO?
Illegal drugs and other drugs of addiction. The most widely used recreational drugs in our society are cigarettes and alcohol. Less commonly used is marijuana. It seems that research into the effects of this drug on foetuses is not yet as available as for the first two. Despite this, it is generally accepted that the fewer chemicals a foetus is exposed to, the better its chances in the uterus and the big wide world. For this reason, most doctors seem reluctant to give marijuana the ‘all clear* for use in pregnancy. It seems likely that there may be a similar effect on the foetus as with heavy alcohol use. If there are ’safe’ levels of usage, it is not clear yet what these levels are.
Amphetamines like ’speed’ are becoming more widely used as a recreational drug, and, while not technically as ‘addictive’ as heroin, they can cause physical symptoms, seen in the babies born of regular users. There may be more chance of problems during pregnancy, small and premature babies, and of the babies suffering from jitteriness and damage to their nervous systems, and having developmental problems later in life.
The effects of heroin on pregnancy have been fairly extensively studied. Apart from an increased risk of miscarriage, small and premature babies, and stillbirth, they can be born with a physical addiction to heroin, and go through ‘withdrawal’. It is not yet certain what the effects of exposure as a foetus has on those children as they grow up. Women who are addicted to heroin may use a substitute, methadone, during the pregnancy, which at least stabilises the dose the foetus receives. The baby will usually still require treatment for its withdrawal.
Cocaine has not really caught on in Australia to the extent that it has in the United States. Research there has shown that it is a pretty nasty drug for babies, particularly in the form of ‘crack’ cocaine. The babies born to mothers who are regular users have significant chances of developmental and psychological problems as they grow up. They are also more likely to be born small and premature.
Benzodiazepines are a class of medication which are used in a couple of distinct ways, therapeutic use and abuse. These medications, of which ‘Valium’ is the most notorious, were developed for their sedative, and anti-anxiety properties. Their use has been controversial over the years, because although they still have a place in the treatment of specific disorders, they have perhaps been overused, often without recognition of the possible consequences of their prolonged use, like addiction.
A woman may have been prescribed a benzodiazepine, for a specific problem, and it may be the most appropriate form of treatment for her. If this is the case, the risks and benefits of its use in her pregnancy should be worked out, in consultation with her treating doctor, and she can make a choice about continuing the medication.
It is thought that occasional use of a night-time sleeping tablet (most of which are benzodiazepines) during pregnancy is unlikely to harm a developing foetus.
Some people use benzodiazepines as recreational drugs, often in conjunction with other drugs. If this is the case, they are usually taken in much larger quantities than the recommended levels, and this kind of use has been shown to have effects on the developing foetus. When born, the baby may go through withdrawal, and there may be a possibility of longer-term developmental problems, affecting memory and learning ability. Research into the effects is continuing.
Women who use drugs, or have a heavy alcohol intake would be advised to have assistance in pregnancy from specialists in this field. There are a number of specialised units set up in public hospitals, which can care for the woman, or give her advice about seeking appropriate assistance.
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