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Pregnancy and Substance Use
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Substance Use Disorders

Pregnancy and Substance Use

To ensure a healthy pregnancy, it is essential to avoid harmful substances including tobacco, alcohol, and drugs, which can cause severe complications for both mother and baby.

Tobacco

Smoking during pregnancy passes nicotine, carbon monoxide, and other harmful chemicals to the baby. Nicotine can damage a developing baby's brain and lungs, while carbon monoxide can restrict oxygen supply.

  • Risks include low birth weight, preterm birth, and birth defects.
  • Higher risk of sudden infant death syndrome (SIDS) during the first year of life.
  • Increased likelihood of long-term health problems such as asthma and obesity.
  • E-cigarettes and secondhand smoke carry similar risks.

Alcohol

There is no known safe amount of alcohol to consume during pregnancy or while trying to conceive. All types of alcohol, including wine and beer, are equally harmful. Risks include growth problems and fetal alcohol spectrum disorders (FASD), a life-long condition causing physical, behavioral, and learning difficulties.

Illegal Drugs

The use of substances like cocaine, methamphetamines, and club drugs can lead to low birth weight, birth defects, miscarriage, and developmental disabilities. Injecting drugs also increases the risk of HIV, which can be transmitted to the baby.

Prescription Drug Misuse

Misusing prescription drugs—such as taking higher doses, using them to get high, or taking someone else's medication—can be harmful. The specific effects depend on the medication being misused.

Opioids

Opioids, including prescription pain relievers (oxycodone, hydrocodone, fentanyl, tramadol) and heroin, pose serious risks during pregnancy. These include birth defects, preterm birth, loss of the baby, and neonatal abstinence syndrome (NAS), which causes withdrawal symptoms in newborns.

Cannabis (Marijuana)

Research links cannabis use during pregnancy to developmental problems in children and teens. The U.S. Centers for Disease Control and Prevention (CDC) advises against using cannabis while pregnant.

Getting Help

If you are pregnant and using these substances, contact your provider to find the right treatment. Do not stop taking opioids or other addictive drugs suddenly, as this can be dangerous for you and the baby; contact your provider for a safe plan to quit.

Frequently Asked Questions

There is no known safe amount of alcohol to consume during pregnancy or while trying to conceive. All types of alcohol, including beer and wine, can cross the placenta and affect the developing fetus. Even low levels of consumption can increase the risk of Fetal Alcohol Spectrum Disorders (FASD), which cause lifelong physical, behavioral, and learning difficulties.
Opioid use, whether from prescription pain relievers or illicit drugs like heroin, can cause birth defects, preterm birth, and miscarriage. A major specific risk is Neonatal Abstinence Syndrome (NAS), where the newborn experiences withdrawal symptoms such as tremors, irritability, and feeding difficulties after birth because they are no longer receiving the drug through the placenta.
Yes, e-cigarettes and secondhand smoke carry similar risks to traditional smoking. They expose the fetus to nicotine and other harmful chemicals that can damage the developing brain and lungs. There is no evidence that e-cigarettes are a safe way to quit smoking during pregnancy, and they should be avoided entirely to protect fetal health.
Smoking introduces carbon monoxide and nicotine into the bloodstream, which restricts the oxygen supply to the baby and constricts blood vessels. This can lead to low birth weight and preterm birth. Long-term, children exposed to tobacco in the womb have a higher risk of developing asthma, obesity, and sudden infant death syndrome (SIDS) during their first year of life.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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