Development in any stage is crucial in some way to a child’s life, though the first and most important pertains to the likelihood that the child will ever see the light of day intact and with all functions working as they should. While many factors can be cited as having a definite effect upon a still-growing fetus, not the least of which are variables that affect the mother in some way, substances taken during pregnancy can often cause the most adverse effects. More than that, such substances can cause effects that might very well go unnoticed until later in life. Regardless of benefit or harm most drugs taken by a pregnant mother will affect a human fetus in some manner.
While this might seem quite obvious to most it is near epidemic levels within the United States, as millions upon millions of mothers who are either pregnant or planning to become pregnant are those who use one or more medications habitually. Many of those documented smoke, drink, or use and possibly abuse medications and illicit drugs both while not pregnant and while pregnant. Many studies have been conducted as to the effects that various substances do to the body and how they can affect a developing fetus. To date many effects have been noted and categorized, but the number of pregnant women that continue suffer from substance abuse has not seen a significant decline.
Much of this issue comes down to overall choice and comfort with the procedures that
are at this time seen as rather harsh or too lax in severity. There is a middle ground in dealing
with pregnant mothers who choose to drink, smoke, or otherwise engage in risky behavior
concerning substances that could be harmful to a developing fetus, but it is largely held by those
who do not know of the problem. Many others would either condemn the act or seek to blame it
upon the inequities of others. While the choice to use or not is ultimately made by the
individual, the consequences of that choice are felt by others and as a result have a greater impact on the pregnant mother.
Surprisingly, substance abuse by pregnant mothers is quite common. Whether it is alcohol, smoking, or using illicit drugs there is a very significant percentage of women who are of childbearing age that are active in the use of such substances. There are also those who are currently on treatments or become eligible for said treatments upon discovering that they are pregnant. Regardless of legality, prescription drugs can be just as damaging to the development of a fetus as any other substance, more so in some cases.
While prescribed drugs often come with some minimal risks the danger is often gauged and found acceptable before such substances can be considered legally and ethically given to pregnant mothers. Other substances however, such as tobacco, alcohol, and illicit drugs can cause irreparable harm to a fetus when taking during the pregnancy. The cessation of using illicit drugs is valued over the removal of smoking during pregnancy, though both can have adverse effects upon a fetus. There are a number of ways that a fetus can be damaged by substance abuse and habitual use of such products, not the least of which would be the damage done to the still-developing brain.
In the worst case scenario a fetus will not survive repeated drug use by a pregnant
mother, as whatever the mother takes into her system is thereby absorbed by the child. Taking
this into account it must also be noted that if a mother is to quit said substances then the
withdrawals she feels will affect not only her, but the fetus as well. Habitual use, harmful as it
can be, will create a dependence within the body upon that substance that, when absent, will send
both mother and child into withdrawals. If not monitored carefully and correctly such weaning
can not only damage both mother and child, but it can cause a miscarriage as well as the body
seeks to purge itself.
Another risk to the fetus, as well as the mother, is the combined use of drugs, or polydrug
use, during pregnancy. While by themselves such substances are normally harmful and even
fatal in some cases to a fetus, taken together the risk only increases as some substances can
actually grow far more toxic when put together (Chen & Maier, 2011). For example when many
illicit drugs are introduced to the bloodstream they are quite harmful in their varied effects and
can cause irreparable damage when used habitually. When used together their effects tend to
combine and create a substance that is twice if not greater in its toxicity than its individual
components. To a developing fetus this is not only harmful to the delicate structure of their bodies, but can cause lasting and debilitating effects upon their mental development as well.
Illicit drugs aside for a moment, it is also unfortunately possible for acceptable,
prescribed drugs to have an adverse effect upon a fetus. While it is typically desired that
pregnant mothers be as substance-free as possible in matters of drugs, smoking, and alcohol
consumption, there are cases in which mothers must take medication for health concerns of pre-
existing conditions that require treatment. For instance a common trait amongst many women of
childbearing age is epilepsy, and must often be treated with antiepileptic drugs, or AEDs. It has
also been deduced that AEDs have been the cause of many malformations and development issues within the human fetus (Kilic, Pedersen, Kjaersgaard, Parner, Vestergaard, Sørensen, Olsen, Bech, Christensen, & Pedersen, 2014).
It is a bit difficult to simply stop treatments that benefit the mother for fear that ceasing
such activities or therapies might not only place the mother in jeopardy, but the fetus as well.
Like anything else the fetus is affected by what happens to the mother and in disregarding safety
in one manner or another it will become dangerous for both individuals. It is commonly seen
only in extreme cases that a child’s welfare will be looked upon a secondary, as the developing fetus is the more important factor to many people, including the pregnant mother. With today’s technology and greater understanding of what causes harm to the development of a fetus it is far more likely that doctors and physicians will be better prepared to weather through many crises that can occur.
Antipsychotics are also drugs that have been shown to have a profoundly noticeable
effect upon the development of a human fetus (Shao, Ou, Peng, Zhao, Chen, & Wu, 2015). The
overall development of children exposed to such drugs has been seen to be largely detrimental,
though several functions have not been as adversely affected. Women who engage in the use of antipsychotics are often made well aware of the risk of continued usage. Discontinuing the use of such drugs would no doubt be just as disastrous as stopping AEDs or even illicit drugs altogether without first being weaned off of them. However, in some cases it would be far worse to stop approved medications altogether without a viable replacement to substitute.
There are a varied and widely observed number of effects that can take place thanks to
the use of substances introduced into the body of a pregnant woman that can affect a fetus.
Many of those can cause low birth weight, mental defects, bodily defects, and even premature
birth due to complications that arise from an altered body chemistry. In the first few weeks of pregnancy the issue is serious enough that the body can enter a phase that is literally all or nothing, meaning that the fetus will be affected and die immediately due to having no resistances, or nothing will happen and development will continue. Generally after this phase development will proceed as is considered normal, but the continued use of drugs will still take its toll upon the growing fetus.
Many different drugs cause many different defects upon a developing fetus. For instance,
thalidomide was observed to cause the severe underdevelopment of the arms and legs and even worse defects within the intestines and heart. Anti-anxiety drugs can be seen to cause exaggerated reflexes in newborns, and other substances such as alcohol can cause mild to severe deformities and the commonly known as fetal alcohol syndrome, or FAS. This can cause a number of defects, among them the failure to thrive, small head circumference, and even mental defects that can mark a child for life.
While there many women who sincerely attempt to quit substance abuse and even to
alleviate how much they take into their bodies during pregnancy, one substance is usually
swapped out for another in many cases. Those women who take illicit drugs have often been seen to switch from harder substances to cigarettes and/or alcohol, which are just as harmful but require much larger doses more often to cause any noticeable defect. Unfortunately as many health professionals do and would most likely always advocate the idea of smoking while pregnant is, while still abhorrent, a decidedly better habit than the use of illicit drugs. The reality of neonatal abstinence syndrome is a likely reason why this is considered such a common practice (Bailey, McCook, Hodge, & McGrady, 2012).
Among all the casualties to development the common thread between all those who use one or more substances is that in time their bodies gain a need for those substances. A buildup of each substance makes the difficulty of quitting increase with each passing use as the body builds up a resistance, then a tolerance, and finally a need. This reaction is a normal, adaptive behavior to not only keep the body from harm but to also increase its ability to deal with a situation that is, by choice, a desired effect. After a while simply quitting does more harm to the mother than continuing to use, and for the fetus the danger is increased almost exponentially in some cases.
While many would insist that such mothers are unfit and unable to care for a child, the
feelings are strong on either side of the spectrum when it comes to punishing the mother for the
act of giving birth to a child that, if they live, could very well become an addict in time. Such
draconian measures as forcing the mother into rehabilitation would likely meet with the same
problems as listed above, and would in some ways seem to violate her constitutional right to
choice. There are also varying opinions that carry the belief that if a pregnant mother is simply
jailed for the act of using illicit substances while pregnant that their accusers will only be locking
her away without addressing the very real issue that drug addiction is a disease as well as a
choice. The mere fact that legislation in some states has called for the indictment of mothers
whose newborns die from their substance abuse is proof that some are willing to look past the idea that something can be done to help such addictions (Scott, 2013).
Teenage females who become pregnant are at an even greater risk. The younger a woman becomes pregnant the more likely it is that a fetus will be underweight or suffer some debilitating defect. Added onto this the fact that teenagers are typically at the highest risk to experiment with illicit drugs, alcohol, and smoking it is even easier to assume that pregnant mothers at such a young age will experience difficulties with their unborn children. Among all pregnant mothers it is more likely than not that that teenage girls who become pregnant would constitute the most high risk participants of any study. It is also likely that they would also be among the least reported among all pregnant women.
Vast amounts of research have been conducted in finding out what use of various drugs
and other substances do to affect a human fetus, though methods that allow scientists the in-
depth knowledge they require have proven sketchy to rather limited at times. What is known is
the effect that many substances have upon the developing fetus, and what needs to be done in
order to stop any further abuse. It is more than a little difficult to convince an individual to
perform an act that they are either not comfortable with or find alien to their regular routine. For substance abuse it is no different save that many afflicted individuals know they should quit, but cannot.
There are a great many substances that can be substituted for the more harmful medicines
and drugs that pregnant mothers are seen to favor, though even these come with drawbacks
occasionally. What works for anxiety might lead to decreased birth weight, abnormalities that
develop thanks to adverse effects from medications, and even infant death upon being born
should the body chemistry of the mother or child prove insufficient to deal with the change. For
all the advances and knowledge taken from hours upon hours of research there are still variables and unknowns that factor into the problem of pregnant mothers who suffer substance abuse. The good news is that much more is known today than in the past, which allows doctors, physicians, and researchers alike to better understand the overall issue and how it might be handled in a more efficient manner.
The morality and ethical issues that arise from substance abuse by pregnant mothers is a complicated and often confusing issue that many have attempted to solve throughout the years. As the issue has continued to rise in severity the numbers have risen as well. Each new generation has managed to present a new addition to the problem, be it the development of psychological issues or new substances that are used either for illicit purposes or to combat existing conditions. In current times the problem has become more apparent that the addiction is the problem, the antecedent to the abuse that takes place, and must be addressed first and foremost if possible. While the harm done to a human fetus is substantial from nearly any substance that is taken by their mother, the underlying cause, if not physical, can be a psychological need that cannot be avoided without help.
References
Bailey, B.A.; McCook, J.G.; Hodge, A.; & McGrady, L. (2012). Infant Birth Outcomes Among
Substance Using Women: Why Quitting Smoking During Pregnancy is Just as Important as Quitting Illicit Drug Use. Maternal Child Health Journal, 16: 414-422.
Chen, W.J.A., PhD & Maier, S.E. PhD. (2011). Combination Drug Use and Risk for Fetal Harm.
Alcohol Research and Health, 34(1): 27-28.
Kilic, D., et al. (2014). Birth outcomes after prenatal exposure to antiepileptic drugs- A
population-based study. Epilepsia, 55(11): 1714-1721.
Scott, A. (2013). Pros and Cons That Affect Pregnancy. Prezi. Retrieved from
https://prezi.com/cn1o1euoykl1/pros-and-cons-that-effect-pregnancy/
Shao, P., et al. (2015). Effects of Clozapine and other Atypical Antipsychotics on Infants
Development Who Were Exposed to as Fetus: A Post-Hoc Analysis. PLoS ONE, 10(4): DOI:10.1371/journal.pone.0123373
