& Drug Use During Pregnancy
Lecture Notes of Terence T. Gorski
March 7, 2002
(Unproofed Draft - Revised
Hello. My name is Terry Gorski. I'm the president of the
CENAPS Corporation, an education, training, and consultation firm
specializing in managing problems related to alcohol, drugs and
Today we have gathered together to celebrate the coming births of many new lives into our
A. There are many
joyful and positive things that will be discussed with you today.
As we begin, you may feel that you won't be hearing any of these joyful
and positive things from me. Why?.
Because I've been asked to discuss a subject that many people see as an unpleasant
and frightening. I've
been asked to talk about what can happen to unborn children when
pregnant women use alcohol and other drugs during their pregnancy.
this topic does contain some some difficult truths, you'' also see that
I'm going to discuss many positive and hopeful things.
this! Imagine that I was here to announce a major breakthrough in
This breakthrough is a simple procedure that all pregnant women could
This major breakthrough prevents
This breakthrough virtually eliminates many of the problems that cause
serious developmental problems that follow children and families for
that thjis breakthrough was able to significantly reduce or eliminate
many of the major birth related problems.
It could reduce or eliminate miscarriages, still births, and
Sudden Infant Death Syndrome (SIDS).
It could reduce or eliminate many complication that lead to the deaths
of mothers during the birthing process.
It could reduce or eliminate birth defects, mental retardation, and many
of the problems associated low birth weights
It could reduce or eliminate mental retardation, many of the learning
disabilities, and attention deficit disorder.
It could siognificantly reduce childhood and adolescent behavior
problems including alcohol and drug abuse, child and adolescent conduct
disorders, rageful behaviors, violence, and crime.
(3) What would
you think if I were to announce this type of breakthrough? You'd probably
think that this was pretty good news. Some of you might even
consider it to a positive and hopeful message.
The fact is, this is exactly the breakthorugh in prenatal care that I'm
gping to announce. And this breakthrough is not knew.
We've known it for decades.
Unfortunately we've done a poor job of letting pregnant women and their
families know about it.
done even a worse job in helpinbg preganant women and their families to
understand how to idetnify and treat a common medical problem that makes
it difficult or impossible for some women to implement this simple
major breakthrough in prenatal care is this:
(1) The use
of alcohol and other mind altering medications and drugs can seriously
harm pregnant women and their unborn children. This harm can
result in the long list of major problems I just listed for you.
Whenpregnant women learn about this potential damage to themselves and
their unborn children, most make a serious decision to stop using
alcohol and other drugs.
(3) 80% of the
preganant wpmen who try to stop using alcohol and other drugs during
preganancy succeed. They stop using alcohol, nicotene, and other
mind altering drugs.
The women who are able to stop using alcohol and other mind altering
drugs during preganancy are able to prevent almost all of the alcohol
and drug-related burth problems and developmental problems that I've
In other words, alcohol and drug related birth and developmental
problems are 100% preventable if women stop using those substance during
(4) If we give
preganant women accurate information about the potential effects of
using alcohol and other drugs on themselves and their unborn
children, 80% decide and are able to stop using these susbstance.
Unfortunately, 20% of women who have been armed with accurate
information about alcohol and other drugs try to stop using but they
can;t stay stopped.
The good news is that we know why most of them can't stop.
They can't stop and stay stopped because they're addicted.
E. Hopefully, several positive things can come out of this
(1) I hope
that after hearing about the damage that can be done, you will
decide not to smoke, drink, use mind altering prescription medication,
or use recreational drugs during your pregnancy.
(2) I also hope
that if you're pregnant and can't stop using alcohol or drugs, no matter
how hard you try -- that you'll know that you and your unborn baby need
You'll know that you have a serious disease or illness called
You'll also have hope because you'll know that addiction is
You'll know that there's effective treatment and caring people willing
to reach out and help you and your family.
(3) I'm also
hopeful that by the time I'm done talking with you, you'll understand
First, you'll understand that Addiction is a genetically influenced
Second, you'll know that the disease of addiction causes your brain to
respond abnormally to the use of alcohol and other mind altering drugs.
And third, you'll know that there are three good indications that you
have the disease of addiction:
First, using alcohol and other drugs will make you feel really
Second, you'll have a hard time thinking and talking about your
alcohol or drug use without becoming angry, defensive, fearful, ashamed or
Third, when you try to stop, you'll feel so bad that you can't
stay stopped. You'll start drinking and using mind altering
drugs in stpite of your commitment to stop. You's start drinking
and using mind altering drugs again even though you know its harmful to
both you and your unborn child. You won't feel good about
it. You'll feel ashamed and guilty -- but you'll go back to
drinking and using prescription or illegal drugs anyway.
In other words, you'll understand that once a person becomes addicted,
she looses the ability to control her alcohol and drug
You'll know that addicted women, even if they're pregnant, can't stop
and and stay stopped even though they see how harmful alcohol and drugs
can be to her, to her unborn baby, and to her family.
In short, you'll know that addicted pregnant may be out of control and
may need get help from trained addiction professionals.
want you to leave this presentation with three messages imprinted upon
The first message is this: Using alcohol, nicotine, mind
altering prescription medications, and recreational drugs are dangerous
to both the mother and the unborn child.
second message is this: Non-addicted women who love and care
about themselves and their unborn child will stop smoking, drinking,
using prescription medications and recreational drugs during
C. The third
message is this: Women who try to stop and can't are
probably addicted and need to seek treatment.
(1) They don't
need to be labeled, judged and punished. They need to be educated
(2) They don't
need to be punished by the courts, they need to be treated by addiction
trained health care professionals.
Let's look at some information from our local area <go
to the article>.
Every day in Hillsborough County, an
average of 75 women await an opening in a publicly funded substance
abuse treatment program.
These women don;t fit the traditional stereotypes of pregnant women with
alcohol or drug problems. Of the women admitted to treatment in
1995 or 1996:
59.7 percent were 31 to 45 years old.
61.6 percent were white (34.9 percent were
black, and 7.3 percent were Hispanic)
66.4 percent had two or more children.
67.9 percent were unemployed, but many were
That's the bad news. But here's some good news.
Addiction is a brain disease that is highly treatable. People can
and do recover with proper addiction specific treatment. Getting
help does work.
people are sick people who need help and not bad people who need to be
people are sick people who need treatment and not criminals who need to
D. The best
way to help women stop drinking and drug during pregnancy is to
recognize addiction as a disease not a crime or a moral defect.
E. The most
effective way to stop drug use among pregnant women is to educate women,
their husbands, and members of the community about three things:
(1) The dangers
of using alcohol and other drugs during pregnancy
fact that most women who keep using in spite of know those dangers are
addicted and need treatment
(3) How to get
pregnant women into effective addiction treatment without putting them
at risk of arrest, imprisonment and loosing their children.
This means training all members of the community, especially doctors,
nurses, emergency services professionals, judges, family law attorneys,
and child welfare professionals.
message must be crystal clear:
pregnant woman who can't or won't stop drinking and drugging is probably
sufferring from a brain disease called addiction that destroys her
normal values, judgment, and impulse control.
pregnant woman who can't or won't stop drinking and drugging is probably
an addicted person with an serious illness that need treatment.
proper first approach to any woman who is using alcohol or other drugs
during pregnancy is:
reach with caring and concern.
(2) To provide
accurate and non-judgmental information, and
(3) To provide
access to effective addiction treatment without putting them at risk of
arrest, imprisonment and loosing their children.
threat of harsh punishment does nothing but drive addicted women
keeps them from getting prenatal care and virtually guarantees two
that most addicted pregnant women will stay addicted throughout their
that they will do serious harm to themselves and their
Using alcohol or other drugs during pregnancy is dangerous for both the
birth mother & her unborn baby. Using alcohol and other drugs
during pregnancy increases the risks of ...
Abruption caused by the placenta pulling away
from the wall of the uterus before labor begins. This condition can lead to
(3) Extensive bleeding
during labor and delivery that can be fatal for
both the mother and her baby.
birth-weight: Babies of women who use alcohol and drug use
regularly during pregnancy are between three and six times more likely
to be born at a low birthweight (less than 5.5 pounds) than babies of
women who do not use the drug.
(1) Low birthweight can result from poor
growth before birth, premature birth, or a combination of both.
babies are 20 times more likely to die in their first month than
(3) Those who survive are at increased risk of
lifelong disabilities including mental retardation, cerebral palsy,
visual and hearing impairment.
Infant Functioning at Birth
sensory-motor responsiveness at birth.
(2) Reduced motor ability
Periods of withdrawal & unresponsiveness
Extended periods of prolonged deep sleep
Periods of agitation marked by being jittery, irritable, restless,
and easily startled by the gentlest touch or sound.
Extended periods uncontrollable crying during which they are very
difficult to calm or comfort
difficulty bonding with the mother or primary care giver
Decreased ability to respond to a
human face or voice
Feeding difficulties including refusal to latch on when mother attempts
to nurse and cycles of refusing to eat and gorging
Defects caused by the adverse effects of the drug upon the
Infant Death Syndrome (SIDS): Greater-than-normal chance of dying of sudden infant death
in child Development: alcohol and drug use exposed children
are more likely to have ...
(1) Slowed or
impaired emotional and cognitive development
development of gross motor skills needed for running, walking,
and hand-eye coordination and fine motor skills needed for
learning to write, draw, and play musical instruments.
lower IQ Scores (about 3 points lower)
(4) More severe
language and learning problems making it more likely that they will need special education to help reach their
Some More Good News: The risk of birth defects and other problems caused by
alcohol and drug use use during pregnancy can be prevented or minimized
by following these guidelines:
A. If you
don't drink or use drugs, don't start.
This will eliminate the possibility of damaging your child by alcohol or
drug use during pregnancy.
B. If you
use alcohol or other drugs, stop before you become pregnant.
If you are using prescription medications, check with your doctor to
assure that they are necessary and safe for your unborn child.
C. If you
can't stop and stay stopped ...
(1) Delay your
pregnancy by using birth control or sexual abstinence
until you have successfully completed substance abuse treatment
and are confident you can keep from using alcohol and other drugs.
substance abuse treatment immediately. If you can't stop using
even though you want to it means that you probably have an alcohol and
drug problem that will require treatment.
If you keep drinking and using drugs it is unlikely that you will be
able to responsibly prevent pregnancy.
If you can't stop using alcohol or other drugs before you get pregnant,
the odds are that you won't be able to stop after you get pregnant.
Using alcohol and other drugs during pregnancy can damage your unborn
child and cause serious problems at birth that can delay their
development and create problems latter in life.
C. If you
are using alcohol and drug use and discover that you are pregnant ...
(1) Stop using the drug
This will reduce the risk of having premature or low-birthweight babies
and of damaging your unborn child in other ways.
Immediately Start Treatment for Substance Abuse.
Without substance abuse treatment the likelihood of returning to
substance us either during pregnancy or shortly after the birth of you
child is very high.
(3) Stay in
substance abuse treatment for the duration of your pregnancy and six
months to one year after the birth of your child.
alcohol and drug use during pregnancy is only the first step in
protecting your child.
regular and heavy use alcohol or other drugs during infancy, childhood,
and adolescence will ...
(1) Prevent you
from being an effective parent
(2) Damage your
(3) Destroy your
marriage and make a healthy relationship with a sober and responsible
You must be alcohol and drug free in order to provide your children with
the quality parenting that they need to avoid future problems.
C. If you
or anyone in your family is abusing or addicted to alcohol or other
drugs you increase the likelihood that your children will be at high
risk of developing serious problems with ...
(1) mental and
easiest part of being a parent is conceiving and delivering the
E. The most
difficult part of being a parent is becoming the type of person who can
teach your child to be a sober and responsible person. Remember we
teach children by both word (telling them) and deed (showing them by
doing it yourself). Out deeds speak more loudly than our words.
Only sober & responsible people are capable of being effective
an effective parent means ...
Being committed to doing whatever it takes to help your children grow
into a healthy and responsible adults. (Being a parent is a
challenge -- bring it on!)
willing and able to meet the basic physical and emotional needs of your
children need at all stages of their development
alcohol and drug free so you can be a good role model for sobriety and
specific parenting skills for ...
toddle and preschool years,
childhood, and adolescence.
E. To be a
quality parent means that you must develop and use ...
(2) a family
management system that meets your needs and needs of all family members
planning and problem solving skills
emotional management skills
11. We are
all capable of being effective parents. All it takes is knowledge,
hard work, and a dogged persistence to keep learning and growing as
people while loving and guiding our children toward the goal of becoming
sober and responsible people. It's hard work, but we can do it!
you for letting me share these ideas with you.
This presentation is meant to
and does not constitute medical advice.