Pregnant people should avoid using tobacco, nicotine, alcohol, and drugs. Even minor use carries health risks for the baby, including short- and long-term conditions.
The American Academy of Family Physicians (AAFP) supports education on the risks of substance use and misuse during pregnancy. The AAFP also recommends that adults who are 18 years or older be screened for alcohol misuse. For people who appear to have a problem, physicians should provide brief intervention, prescribe treatment and refer to counseling.
Path to improved health
Stop using tobacco/nicotine, alcohol, and drugs if you are pregnant, trying to become pregnant, or think you may be pregnant. Harm may occur at any time during pregnancy. Talk to your doctor if you need help quitting.
Tobacco/Nicotine
Smoking can increase your risk of miscarriage and preterm birth. Your baby could have a low birth weight or certain birth defects. Smoking during or after pregnancy also has been linked to sudden infant death syndrome (SIDS).
Other tobacco products, such as e-cigarettes, carry the same risks as smoking. There is no safe amount of tobacco or nicotine at any time in your pregnancy. Quitting smoking improves your health and your baby’s health. You should also avoid secondhand smoke when pregnant.
Alcohol
Alcohol use during pregnancy can cause birth defects and result in fetal alcohol spectrum disorders (FASDs). FASDs are a group of conditions that can occur in a person who was exposed to alcohol during pregnancy. The effects can include physical problems and problems with behavior and learning. Often a person has a mix of these problems.
There is no known safe amount, type or time to drink during pregnancy.
Drugs
Using recreational drugs such as cocaine, opioids, amphetamines (heroin/fentanyl), and cannabis carry major risks. They can cause miscarriage, preterm birth, and birth defects. Your baby could go through drug withdrawal shortly after birth. This is called neonatal abstinence syndrome, which is very painful. It often has lasting health effects.
The use of opioids during pregnancy can be harmful as well. You could have placental abruption (the placenta separates early from the uterus), or your baby could have fetal growth problems. If you take opioids for a medical issue, talk to your doctor about when and how to quit. If you have an opioid addiction, your doctor may provide medication-assisted therapy (MAT).
Once you know you’re pregnant, talk to your doctor about all the medicines you take. Some prescription and over-the-counter (OTC) drugs are okay to use, while others are not. For some medicines, you may need to switch the dosage or type. Do not stop or start using a new drug without talking to your doctor first. This includes vitamins and supplements.