I'm Sorry for My Loss by Rebecca Little & Colleen Long

Author:Rebecca Little & Colleen Long [Little, Rebecca & Long, Colleen]
Language: eng
Format: epub
Publisher: Sourcebooks

Drug Use and Pregnancy Loss

There are few studies that identify a direct link between substance abuse and stillbirth, according to a review of medical studies done in 2018 by researchers at the University of Hawaii. Restricted fetal growth was the most common complication in all types of substance abuse, they found.9

Dr. Claire Coles, a professor of psychiatry and behavioral sciences and director of the Maternal Substance Abuse and Child Development program at Emory University in Georgia, has, for more than forty years, studied teratogens, which are substances that cross the placental barrier and interfere with normal fetal development and may cause problems in utero and out. Alcohol is one example; drugs are another, including legal medication. Her program is the data mother ship on what environmental or ingested substances travel from mother to baby. She has a huge body of work, including a recent publication titled “Fifty Years of Research on Prenatal Substances: Lessons Learned for the Opioid Epidemic.”10

“It’s interesting,” she told us. “When we started with alcohol in 1980, nobody was interested in hearing about this. People have always been sort of aware there are issues there, but they mostly ignored it. There was this (wrong) idea that the placenta would protect the baby from whatever. It was a solid barrier.”11

But it turns out it’s not much of a barrier after all, and most things get into the bloodstream, including drugs (legal and illegal), alcohol, poisons like mercury and lead, and pollutants. But according to Coles, it isn’t that teratogen automatically equals infant death. The reality is far more complex, as are the ideas on how to deal with teratogens and perceived teratogens.

“There are lots of different strings that get involved in this,” she told us. “How we regard women and pregnancy and all that. If you’re using cocaine, anything wrong with a child must be your fault. Alcohol is more complicated because it’s legal and accepted.”

Coles studied women who were roughly thirty-four weeks pregnant and above and who were serious crack cocaine users. She followed 110 children for more than twenty years. She compared the kids who were exposed to the drug in utero with those who grew up as their neighbors and found very little difference.

This is not to say that she—or we for that matter—condone drug use during pregnancy. Children born addicted to substances go through withdrawal and can have lifelong complications, physically, mentally, and emotionally.12 The question is whether there’s a scientific basis to charge someone with a crime or whether it’s moral panic on the part of the lawmakers. And there’s no easy way to answer it.

“I think the fear of these things is used to punish women,” Coles said. “Get the law out of it. That is what I believe. On the other hand, I run a clinic in which we see children alcohol- and drug-exposed. The stories we hear would take the paint off the walls. Yes, there are people who shouldn’t be having children.”13

“But it’s a very complex and difficult issue,” she went on.

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