Anxiety. Fear. Remorse. Shame. These are not the feelings we normally associate with pregnancy and, in great degrees, they can even be harmful to mother and baby. Yet women who are pregnant and addicted to alcohol or drugs often feel overwhelmed with these emotions to the point that they reject any help and refuse vital prenatal care.
In a perfect world, women would not abuse drugs or alcohol while they are pregnant. It is well established that the use of tobacco, alcohol, or illicit drugs or misuse of prescription drugs by pregnant women can have severe health consequences for infants. Recent research shows that smoking tobacco or marijuana, taking prescription pain relievers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth and, similarly, heavy alcohol use in pregnancy has been associated with a range of negative birth outcomes. Still, estimates suggest that about 5 percent of pregnant women use one or more addictive substances. In all, over 380,000 babies are exposed to illicit substances, over 550,000 are exposed to alcohol and over one million are exposed to tobacco in utero.
These risks and statistics underscore the fact that we need to do a better job getting addicted mothers-to-be the treatment they need, and not judge or punish these women as some believe. Studies have shown that incarceration and the threat of incarceration have proven to be ineffective in reducing the incidence of alcohol or drug abuse, pregnant or not. The American College of Obstetricians and Gynecologists agrees, stating that current punitive drug enforcement policies often deter women from seeking prenatal care which is contrary to the welfare of the mother and fetus. The group states, “Seeking obstetric-gynecologic care should not expose a woman to criminal or civil penalties, such as incarceration, involuntary commitment, loss of custody of her children, or loss of housing. These approaches treat addiction as a moral failing. Addiction is a chronic, relapsing biological and behavioral disorder with genetic components. The disease of substance addiction is subject to medical and behavioral management in the same fashion as hypertension and diabetes.”
Women who are pregnant and struggling with addiction deserve to be treated with dignity, not disapproval. They should feel safe coming forward to seek help and not be shamed for their past actions. Doctors can educate them about the risks, to be sure, but shame has no place in a medical office and is counter-productive to encouraging changed behavior. Sadly, in one study, women who abused drugs did not trust their health care providers to protect them from social and legal consequences and abstained from prenatal care altogether. Some women suffer familial and public judgment, and fear their doctors will do the same, so avoiding the situation becomes easiest. The irony is that many of the health problems associated with substance use in the prenatal period could be avoided given effective and well-timed medical care or intervention. That is, the sooner they seek care, the better.
If a woman is pregnant and struggling with addiction, it is vitally important that she not let shame stand in her way of getting treatment. “Shame corrodes the very part of us that believes we are capable of change,” says renowned shame expert and author Brene Brown. Healthier choices can start right now and fortunately, there are substance abuse treatment programs that provide specialized services for pregnant women. Some even provide family services and valuable parenting skills training. Such substance abuse treatment programs that integrate prenatal care have proven to be effective in reducing maternal and fetal pregnancy complications and costs.
It comes down to this: if our goal truly is for a healthy mother and baby, support not shame, care not condemnation, will get us there. If you or a loved one is pregnant and has an addiction to drugs and alcohol, Recovery Centers of America’s Pregnancy and Parenting Program can provide the specialized treatment necessary for both mother and baby’s long term health in an atmosphere of dignity without shame.