Q&A: Is It Safe to Use Drugs During Pregnancy?

Question

Are there any recreational drugs that are safe to take when pregnant (weed?), and if not, what are the biggest no-nos?

–Anonymous

Answer

From the mercury in your fish sandwich to the weed killer on your lawn, hazards to your unborn baby are everywhere.  Because toxins pervade our food, water and air, many of these dangers are unavoidable.  Fortunately, recreational use of drugs and alcohol is one risk factor that can be completely eliminated.

According to Merck.com, more than 90% of pregnant women take prescription or over-the-counter drugs, use social drugs like tobacco and alcohol or illicit drugs at some time during pregnancy.  That’s a lot.  About 2 to 3% of all birth defects result from the use of drugs other than alcohol.  While this number may seem small given the large number of women who take drugs and medications during pregnancy, birth defects aren’t the only complications that can occur.  Miscarriage, premature birth, neurological and developmental disorders are some of the possible outcomes of drug abuse during pregnancy.

The fetus is particularly vulnerable to birth defects between the 3rd and the 8th week after fertilization when its organs are developing.  Drugs taken after this period are unlikely to cause birth defects, but they can alter the growth and functioning of organs.

Here’s a breakdown of the most common drug classes and their relative safety:

  • Stimulants:  (Caffeine, amphetamines, cocaine, nicotine)  These drugs generally put the baby at risk for premature birth and low birth weight, though smoking tobacco also increases the risk for SIDS and miscarriage.  They can also speed the heart rate of both mother and child, which is particularly unsafe if heart defects are present.  Amphetamines are a Pregnancy Category C drug, meaning they have caused birth defects in animal studies but their risk to humans is unknown.
  • Depressants:  (benzodiazepines, barbiturates and sedatives)  Drug Information Online states that diazepam (Valium) may be particularly harmful to the fetus and has been linked with several congenital malformations.  Alprazolam (Xanax) is also a Category D drug, meaning it should not be taken during pregnancy.  Regular use of barbiturates during pregnancy may lead to bleeding problems in the baby as well as withdrawal symptoms upon birth, which can be fatal.
  • Hallucinogens:  (LSD, mescaline, psilocybin, MDMA)  The effects of hallucinogens on the fetus are not well documented, though specific birth defects have occurred in babies whose mothers took LSD, mescaline or MDMA during pregnancy.  Overall, there is a lack of epidemiological evidence showing that hallucinogens adversely affect pregnancy outcome, making it impossible to determine their safety. In general, taking hallucinogens during early pregnancy is more likely to result in birth defects than taking them in late pregnancy.
  • Opiates: (Opium, heroin, morphine, oxycodone)  While not known to cause birth defects, opiates readily cross the placental barrier and can cause addiction in newborns.  Opiate use may also lead to an increased risk of miscarriage, preterm delivery and low birth weight, particularly in heroin abusers.  IV use of opiates or other drugs puts the baby at risk of fatal infections like hepatitis C, HIV and sepsis.  Most opiates belong to Pregnancy Category C due to an unknown risk of harm to the fetus.
  • Dissociatives:  (PCP, ketamine, DXM, nitrous oxide)  According to the Illinois Teratogen Information Service, high doses of PCP during pregnancy have been linked to cleft palate, skeletal dysplasias and other birth defects in animals and isolated cases of birth anomalies in humans.  DXM is safe in recommended doses, though recreational amounts may not be safe.  Nitrous oxide belongs to Category C, making it potentially unsafe for pregnant women.
  • Marijuana:  Occasional use for morning sickness or the pain of childbirth is unlikely to cause lasting damage to the fetus.  Frequent smoking of marijuana during pregnancy has been linked to low birth weight and withdrawal-like symptoms (irritability, crying, restlessness) in newborns similar to that seen in cigarette smokers.  Logically, if one is going to use marijuana during pregnancy, it would be best to avoid smoking and opt to eat or vaporize the herb to avoid inhaling carbon monoxide and other harmful compounds.

In the grand scheme of things, 9 months isn’t that long to avoid using drugs, so if you aren’t willing or able to wait, it might be best to put off having a baby.  As moms everywhere will tell you, your child’s health and well-being should come before everything else–even your own pleasure.  Like other vices, frequent drug use costs money and impairs your ability to give your baby the love and supervision it needs.  While I would lay down my life for an adult’s right to do what they want with their bodies, I believe that freedom stops when it involves harm to another person.  A baby has no choice in the matter, making drug use while pregnant a selfish and immature act.  (Note:  These statements aren’t aimed at you, Anonymous, as I’m sure you understand the risks.  Heck, I don’t even know if the question pertains to you, but there are people out there who don’t think about these things and need to hear it.  Rant over).

To recap:

Drugs you should always avoid while pregnant:

  • Alcohol
  • PCP
  • IV drugs (heroin, cocaine, etc.)
  • Inhalants (glue, paint, gasoline)

Drugs you should probably avoid while pregnant:

  • Benzodiazepines
  • Barbiturates
  • Stimulants
  • MDMA

Drugs that may be safe in moderation while pregnant:

  • Marijuana (eaten or vaporized)
  • Psilocybin mushrooms, LSD and mescaline

Love and Light, Mommies.  Stay Safe,

Mary Microgram

References

Merck:  http://www.merck.com/mmhe/sec22/ch259/ch259a.html

Drug Information Online: http://www.drugs.com/valium.html

Illinois Teratogen Information Service: http://www.fetal-exposure.org/resources/index.php/2000/10/01/the-effects-of-hallucinogen-use-during-pregnancy/

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