Pregnancy after a youth of drink and drugs?

June 4, 2008 9:05 AM

Assuming a woman has given up alcohol, to which she was strongly attached for 15 years, and has also given up cocaine and ecstasy (MDMA), which she used regularly, and she is now drink and drug free: could this past of substance-abuse affect her pregnancy in any way? And if so, what could she do to minimise the effects? For clarity: she's not pregnant at the moment, but would like to have a baby.

(Everything I turn up on Google relates to the use of alcohol and drugs during pregnancy, not before.)

posted by londongeezer to health & fitness (16 answers total)

I don't think it would, but to be sure, I'd ask my OB/GYN.
posted by cahlers at 9:56 AM on June 4, 2008

IANAD, but my understanding is that these substances flush out of the imbiber's system after a few days or weeks. There may have been physiological damage to the mother's liver, but this is unlikely to damage the fetus. I don't believe that MDMA or cocaine have any genetic effects. A solid course of prenatal care (with all the attendant bloodwork and vitamins) is certainly a good idea.

Also, this person is likely to have some psychological issues that led to the years of substance abuse. I'd be very concerned about making it through the post-partum phase without falling back on these old bad habits as a crutch; it would probably be a wise idea to include a therapist (if there isn't one involved already) to make sure she's ready to go.
posted by jenkinsEar at 9:56 AM on June 4, 2008

i am not a doctor, but i would assume that if she is healthy (has suffered no organ damage from her addictions) and has been drug free for long enough to reasonably ensure her continued sobriety through pregnancy, she'd probably be fine.

her gynecologist might be a better resource, though.
posted by thinkingwoman at 9:57 AM on June 4, 2008

IANAD, but certain drugs (PCP, THC) accumulate in the body with chronic use. Furthermore, alcoholism tends to deplete certain vitamins, so depending on how long your friend's been clean, she could still be depleted in thiamine, folate or other vitamins that affect pregnancy. Clearly the hivemind doesn't know all the pertinent details, so your friend definitely needs to see an OB/GYN and let the professionals take care of it.
posted by desiderandus at 10:01 AM on June 4, 2008

Right off the bat, this woman may want to see a doctor in advance of becoming pregnant. Google is a very dependable source of information, but the risk of screwing up your google-fu would be VERY HIGH here. Said woman should talk to a doctor who is an addiction specialist.

Besides that, here are some long-term effects of cocaine (which may be exacerbated because of the extra stress on one's body due to pregnancy):

# Cardiovascular problems, including irregular heartbeat, heart attack, and heart failure
# Nausea, and headaches
# Neurological incidents, including strokes, seizures, fungal brain infections, and hemorrhaging in tissue surrounding the brain
# Pulmonary effects, such as fluid in the lungs, aggravation of asthma and other lung disorders, and respiratory failure
# Psychiatric complications, including psychosis, paranoia, depression, anxiety disorders, and delusions
# Increased risk of traumatic injury from accidents and aggressive, violent, or criminal behavior

A lot of the above may not strike you as "that dangerous", but add the likelihood of that to the possibility of postpartum depression.

As for the ecstacy, the only long-term effects that I know of (if said person is "fine" right now), is the messing up of your serotonin levels. That can cause anything in the range of irratability to suicide to murder.


YES, I am totally stating the more dangerous effects. Hopefully this will get the person to go see a doctor who is also an addiction specialist who may be best able to assess risks and possibly instruct the said person to lower those risks.

Good luck.
posted by hal_c_on at 10:02 AM on June 4, 2008

Yeah, this isn't something you want to chance to "probably be ok". GO SEE A DOCTOR AND REVEAL EVERYTHING TO THEM! If your ob/gyn has a "you'll probably be fine", go see another doctor. Get to an addiction specialist who may be able to tell you possible risks and how to decrease them.

PLEASE.

Good luck!
posted by hal_c_on at 10:04 AM on June 4, 2008

I don't have an empirical answer but someone I know very well was in exactly this situation and now had a perfectly healthy, happy baby. I don't believe there to be any risk at all.
posted by Lleyam at 10:11 AM on June 4, 2008

has a perfectly healthy, happy baby...
posted by Lleyam at 10:12 AM on June 4, 2008

Agreed. Go see an OB now, before she gets pregnant. Pregnancy is a huge stress on a body, and her body has already been stressed by all the drugs she's used.
posted by gramcracker at 10:16 AM on June 4, 2008

What Lleyam said. Honestly, I'm always amazed by the people who think you should go to the doctor on a daily basis and for every single little question in the world. I mean, if she hasn't been to a doctor in fifteen years, then, yeah, she should have a checkup. However, presuming that she's been going to the ob/gyn once a year for the regular, chances are she's fine. Women are designed to get pregnant; their bodies know what to do. Barring significant health issues like diabetes, it's not a "huge stress" for the most part. And I know quite a few people who did lots and lots of drugging and drinking before they decided to settle down and have kids. The kids are fine. The moms are fine. As long as she's not doing it while she's pregnant or nursing, it shouldn't be an issue.
posted by mygothlaundry at 11:04 AM on June 4, 2008

See this link for a nice description of germline vs. soma. The cells your body will use to reproduce are formed very early in development.

"By the 15th week of gestation, the human female fetus has already set aside each and every cell that may someday develop into a mature egg." This is nice because your baby is being formed from relatively fresh, new cells, not cells that are a copy of a copy of a copy (etc) of cells that have been dividing your whole life. This protects from a lot of dna mutation, so, yay. I am sure a biologist will chime in soon and explain it better. Personally I like the idea that my babies were formed out of cells made when I was a fresh, new baby myself, not the wretch I have become in my 30s.

Seems to me her main focus should be on replenishing vitamins. Alcoholics are typically low on lots of vitamins (thiamine is the common one), so it seems likely that heavy drug & alcohol use might have left her low. Just take all the supplements your doctor gives you. There are some freaking awesome prescription prenatal vitamins now, which you can start taking pre-conception. I loved the PrimaCare One vitamin.
posted by selfmedicating at 11:10 AM on June 4, 2008

I don't have an empirical answer but someone I know very well was in exactly this situation and now had a perfectly healthy, happy baby. I don't believe there to be any risk at all.


This is not evidence.

Plenty of healthy women go to the OB-GYN just to get some basic advice, a pre-conception diet, and an OK-GO-GET-LAID! It won't hurt a thing (unless they're particularly insensitive with the pelvic...ouch).
posted by sondrialiac at 12:19 PM on June 4, 2008

Oh, precisely-anecdote is not evidence.

I think the MD checkup is an excellent idea, along with blood work and preconception vitamins.

The drug molecules have left the body after a decent amount of time has passed-and whatever organ damage she has suffered, she has suffered. There's not likely to be that much more healing going on between now and the time of conception.

The psychological angle is what would concern me. I've never partaken, myself, but I don't think I am stretching credulity to suggest that someone who has drunk and drugged to that extent is not entirely mentally healthy. Pregnancy is certainly an enormous drain on mental, as well as physical, energy, and some treatment in that regard is certainly called for.
posted by spudrph at 1:31 PM on June 4, 2008

I learned to drink in order to deal with stress. I've been sober a very long time, but in moments of extreme stress, I still want to. Depending on why your friend used/drank, this may be something she may want to keep in mind.

Parenting and new-motherhood have, obviously, a huge impact on your life, and plenty of people who've never had substance issues find themselves floundering.

Making sure she has a solid support system of friends and/or family, that she's as prepared as possible for the physical and psychological changes, etc., will help her be a healthier mother and a healthier person overall.
posted by ElaineMc at 3:46 PM on June 4, 2008

Let me put a disclaimer on this, that this is second hand knowledge and purely anecdotal. But a good family friend had a child who was born with severe water on the brain. The child only lived to be about 12 and was severally disabled. The doctors didn't know what caused the birth defect, but told the mother that (and I have no idea the actual causes here) it could have been caused by her brief, but heavy drug in college in the 70's. The child was born probably about 5 years after the heavy drug use and she certainly wasn't using at the time. The Drs could have just been randomly hypothesizing, I was never too clear on how certain the Drs were or what specific damage it did to her body that caused the birth defect, but I would at least go to the Dr before conceiving. I should also say she then went on to have two perfectly healthy children, so take it with a grain of salt.
posted by whoaali at 5:17 PM on June 4, 2008

IANAD, but I do work for one, so I know a little about referrals and resources.

There's an organization/clinic in Toronto devoted to this sort of thing (website: http://www.motherisk.org/women/index.jsp). They have a big campaign on now for women who have just found out they're pregnant, but they seem to cover all the bases (past abuse, recent past abuse, current abuse, prescription drugs, over the counters, herbal supplements etc etc). If they (or their website) don't have sufficient answers, they can probably refer you to a local resource.

In a perfect world, your friend could find, afford, and get in to see a substance abuse specialist OBGYN, but (at least here in Toronto) it's difficult enough getting in to see any OBGYN when you're pregnant. She may have to do some or all of the research on her own.
posted by sarahkeebs at 1:15 PM on June 5, 2008