Healthy Moms and Healthy Babies

Our goal at Milford Regional Medical Center is to help both moms and babies have a healthy pregnancy. There are many things that your baby will be exposed to while growing inside of you. You can help control what your baby is exposed to by limiting certain foods and drinks, by only taking medications that are prescribed for you by your provider, and by avoiding cigarettes/marijuana and second-hand smoke.

Your obstetrical office will help with any questions/concerns that you may have about you or your baby’s care during pregnancy. Your doctor will ask you a series of questions about your medical history. Some of these questions will be about past and present use of alcohol, drugs and tobacco/marijuana use. They will ask about the father’s history and they may also ask about family history. All patients are asked these questions. We encourage you to answer these questions honestly so that we may provide the best prenatal care possible for you and your baby.

Tobacco

Smoking during pregnancy is not only harmful to you, but it is also harmful to your baby. When you smoke during pregnancy, your baby is exposed to harmful chemicals, including nicotine, carbon monoxide and tar. These chemicals can decrease the amount of oxygen that your baby gets. Nicotine easily crosses the placenta to the baby and concentrations in the fetus can be as much as 15% higher than levels in the maternal circulation. Nicotine has been found to concentrate in fetal blood, amniotic fluid and breast milk. Infants exposed to nicotine during pregnancy are at risk for low birth weight, premature delivery, cleft lip/palate, stillbirth, heart defects and an increased risk for SIDS.

Marijuana

Marijuana contains many of the cancer-causing chemicals found in tobacco. It can also be laced with other substances including embalming fluid, ketamine and cocaine. The effects of one joint on the respiratory system are similar, if not worse, than that of 5 tobacco cigarettes. THC, the main chemical in marijuana, concentrates in breast milk. Breastfeeding is not recommended with marijuana use. Infant risks are similar to nicotine exposure. Infants may also exhibit signs of withdrawal including irritability, high pitched cry, tremors and abnormal responses to visual stimuli.

Alcohol

Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces, by far, the most serious neurobehavioral effects in the fetus. (Institute of Medicine Report to Congress, 1996)

Fetal alcohol spectrum disorder (FASD) is the most common preventable cause of mental disability in the western world.

NO AMOUNT OF ALCOHOL HAS BEEN PROVEN TO BE SAFE DURING PREGNANCY!

Infants who are exposed to alcohol during pregnancy can have low birth weight, growth impairment, central nervous system abnormalities, irritability, poor sleep habits, poor feeding, agitation and increased risk of neonatal death. If you are dependent upon alcohol, it is important to let your provider know, both for your safety as well as the safety of your unborn child. The safest way to detox from alcohol during pregnancy, is in an inpatient/hospital setting. Resources are available to you. Your health and the health of your unborn child are our top priority.

Opioid Medications & Treatment

Opioids are medications that are prescribed for pain. When used properly, they can help you manage pain safely. Your provider can discuss safe pain management options with you. It is important to inform your provider of any and all medications that you are currently taking.

Prescription drug abuse is using a prescription drug in a way other than ordered by your provider. This includes taking more than the recommended dose, buying prescription drugs not prescribed for you, or taking someone else’s prescribed pills. If you are dependent upon opioids, it is important that you don’t stop taking them suddenly. This can cause you to go into withdrawal and could be harmful to you and your baby. It is important to speak to your provider about medication-assisted treatment (MAT). Two medications are currently used for treatment of opioid addiction. They are Methadone and Buprenorphine (Subutex). Your provider can discuss which option is better suited for you.

Infants exposed to opioids during pregnancy are at higher risk for low birth weight, premature delivery, feeding problems, respiratory conditions and neonatal abstinence syndrome (NAS). NAS is a group of withdrawal symptoms that infants may experience due to drug/medication exposure in utero. We will review NAS with you during your pregnancy, if your baby is at risk for it.

Heroin

According to the Massachusetts Department of Public Health in 2005, heroin was the primary substance of abuse in 54% of pregnant women admitted to medication-assisted treatment programs. Risks to the newborn are the same as opioid exposed infants. However, there is an increased risk to the mother of contracting HIV or other infections related to IV drug use. If the mother contracts an infection, there is a risk of it being passed on to the newborn.

Resources

Centers for Disease Control (CDC): www.cdc.gov/pregnancy/meds/index.html

Institute for Health and Recovery: www.healthrecovery.org

Organization of Teratology Information Specialists: www.OTISpregnancy.org

National Institute on Drug Abuse (NIDA): www.drugabuse.gov

Substance Abuse and Mental Health Services Administration (SAMHSA): www.samhsa.gov

American Academy of Family Physicians: www.familydoctor.org