If you are using illegal or street drugs, it can make you feel isolated. But you are not alone. Illegal drugs are more commonly used than you might realise. About one in five young adults aged between 16 and 24 has used them in the past year (Home Office 2012).

This article explains how different drugs can affect your pregnancy and your baby. The more facts you know, the better your choices will be. And if stopping drugs is a problem for you, getting help is a big step towards giving your baby a healthy future.

Your GP or midwife can help you get treatment and other support. For example, you may need support from a health professional with extra experience in looking after pregnant women who use drugs (NICE 2010).

Is it safe to take illegal drugs while I'm pregnant?

For some drugs the evidence is clear, for others less so. But we know enough to be sure that illegal drugs in pregnancy must always be considered unsafe, even in small amounts.

If a parent has drug problems it affects their child at every stage, from pregnancy onwards (ACMD 2012). Now that you're pregnant, it's a really good time to make a change to give your baby a good start in life.

How do drugs affect my baby?

Almost all drugs pass through the placenta to reach your baby and have some effect on her (Behnke et al 2013).

Drugs in your body may reduce the amount of oxygen that can reach your baby. Early in pregnancy, some drugs may affect your baby's development. Your baby may not grow as well as expected in your uterus (womb) (Behnke et al 2013).

Taking illegal drugs may cause problems later on in your pregnancy, too, as they can affect how well the placenta works. There is a risk that the placenta may come away from the side of your uterus, sometimes causing severe bleeding. This is called placental abruption. Placental abruption is a serious condition and, because of the bleeding it causes, it can be life-threatening for you and your baby.

Your baby may have withdrawal symptoms if you regularly take certain drugs during your pregnancy. Your baby may need to stay in hospital, so nurses and doctors can check her for signs of withdrawal, and give her treatment (Hamdan 2012).

What if I took drugs before finding out I was pregnant?

We know many people take drugs as part of their social life. If you took a drug without realising you were pregnant on a one-off occasion, try not to worry because it's very unlikely to have affected your baby.

However, if illegal drugs are part of your life, getting help can really improve the outlook for you and your baby.

Which drugs have which effects?

Here is what we know so far about the effects of illegal drugs:

Cannabis (marijuana)

Cannabis is the most widely used illegal drug (Home Office 2012). Taking cannabis during pregnancy might make your baby unsettled and more easily startled after he is born. In the longer term, it could cause behaviour and learning problems for your baby as he grows older (Behnke et al 2013).

Smoking cannabis also exposes your baby to the risks related to smoking. If you smoke, you are more likely to go into premature labour. There's also a higher chance that your baby will be born with a low birth weight and other complications, and it increases the risk of cot death. (CDC 2013)

Speed (amphetamines) and crystal meth (methamphetamine)

It's best for your baby if you stop taking speed or crystal meth before you get pregnant. You can still quit if you are pregnant, but to be safe, you should stop taking these drugs with medical help in a drug treatment programme. Stopping suddenly could be harmful for you or your baby and could cause miscarriage.

Taking speed or crystal meth can make the following more likely:

a complication where the placenta can't carry enough oxygen and nutrients to your baby, called placental insufficiency

(Hudak et al 2012)
These drugs can affect your baby's growth in the uterus, making her smaller than expected for your stage of pregnancy (Nguyen et al 2010) and increasing the chance of premature birth (Hudak et al 2012).

Some babies may have withdrawal symptoms but there are not many studies on this problem (Hudak et al 2012).

We also lack full information about the lasting effects of these drugs as your child grows up. But it's possible that children exposed to these drugs in the uterus may not develop and learn as well as other children their age (Behnke et al 2013, UKTIS 2012).

Ecstasy

There's a lot of concern about the long-term side-effects of taking ecstasy. But there's very little research on the way that it can affect your pregnancy or your baby (Singer 2012, UKTIS 2011a). Ecstasy may have an effect on your baby's motor development (co-ordination and movement) (Singer 2012). There is limited evidence that it could cause birth defects, but we don't know for sure (Singer 2012, UKTIS 2011a).

Cocaine and crack cocaine

Taking cocaine or crack during pregnancy may increase your risk of having a miscarriage, and of placental abruption (Hamdan 2012, UKTIS 2011b) later in pregnancy.

Using cocaine while you are pregnant can slow down your baby's growth in the uterus. It may also increase the risk of your baby having problems with learning and behaviour when he is older (Behnke et al 2013).

Heroin and strong painkillers

Heroin has serious risks for your baby. The same kind of problems can happen if you are regularly using related painkillers (opioids) like morphine or Tramadol during pregnancy. You may not realise that you can become addicted to strong painkillers (ACMD 2013).

If you use heroin or other opioids, it is vital to get treatment as soon as you can. Trying to quit on your own could be dangerous for you and your baby. It could cause a miscarriage or premature birth, or your baby could be stillborn (Behnke et al 2013). The safest way to quit is with medical help, as part of a drug treatment programme.

During pregnancy, heroin and other opioids can slow down your baby's growth and have an effect on how her brain grows (Behnke et al 2013). These drugs can also make it harder for your baby to breathe just after she is born.

One of the most serious problems for your baby is withdrawal symptoms when she is born (Behnke et al 2013, Hudak 2012). Your baby will need special care in hospital if she has withdrawal symptoms.

As she grows older, your child may have behavioural problems. Experts are not as sure about growth and intelligence, but these may be affected, too (Behnke et al 2013).

Where can I go for support and information?

If you are taking illegal drugs it is really important to talk to your midwife or doctor. They need to know you are taking drugs, so that they can give you the right care and support during your pregnancy.

Your midwife or doctor won't judge you for taking drugs. Telling them about the drugs shows how much you care about your baby. It's the job of your midwife and your doctor to look after you as best they can. So the more they know, the more they can help you and your baby to get the right treatment.

Home Office. 2012. Drug misuse declared: findings from the 2011 to 2012 Crime Survey for England and Wales (CSEW) (second edition). Section 2.2: Extent and trends in illicit drug use among young people aged 16 to 24. www.gov.uk [Accessed May 2013]

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