One of the most important things in your life right now is ensuring the health of your unborn baby. A few changes in your life could make a critical difference to your baby's health. Take time to understand the risks and the steps you can take to increase your chances of having a normal, healthy baby. Regular visits to the doctor, a nutritious diet, and moderate exercise are important during pregnancy. But an expectant mother as well as a woman who is planning to conceive also must avoid use of alcohol, tobacco, and street drugs. And, she must be very careful about the kinds and amounts of over-the-counter and prescription drugs she takes.

Scientific studies show that using alcohol, cigarettes, and other drugs while pregnant - especially during the earliest stages of pregnancy -increases your baby's risk for serious illness, birth defects, developmental problems, and even death. Research also shows that the sooner you stop drinking, smoking, or using drugs, the better your chances of having a healthy pregnancy and a strong and healthy baby.

Alcohol: A Powerful Drug

Most of us don't think of alcohol as a drug. Yet beer, wine, liquor, and wine coolers all contain alcohol, a central nervous system depressant that affects nearly every organ in our bodies.

Drinking, especially heavy drinking, over a period of time can contribute to a number of serious problems, including muscle and heart disease, malnutrition, digestive and liver problems. It shouldn't be surprising that this powerful, addictive drug, when used during pregnancy, can affect the delicate and developing system of the unborn baby.

During the last two decades, researchers have conducted a number of studies of infants born to women who drank heavily (an average of five drinks per day) during pregnancy. The results are disturbing. A significant number of the infants studied were born with a pattern of physical, mental, and behavioral abnormalities that researchers have named the "fetal alcohol syndrome (FAS)." These problems appeared to be more severe among newborns of women who drank heavily during the last three months of their pregnancy.

FAS babies weigh less and are shorter than normal, and they don't catch up even after special postnatal care is provided. They have smaller heads, malformed facial features, abnormal joints and limbs, heart defects, and poor coordination. Most children with FAS also are mentally retarded and show a number of behavioral problems, including hyperactivity, extreme nervousness, and poor attention spans. And, these problems persist into adulthood.

Not all women who drink heavily during pregnancy deliver babies with FAS. But many women who drink deliver babies with at least several of these alcohol-related birth defects. And, pregnant women who consume between one and two drinks per day are twice as likely as nondrinkers to have a low birth weight baby.

How Alcohol Affects the Unborn Baby

Whenever you take a drink, the alcohol readily crosses the placenta and enters the baby's bloodstream However, the baby's tiny developing system is not equipped to handle alcohol and is affected much more severely than is the mother. Every time you take a drink, your unborn baby drinks as well.

Now Much Drinking is Harmful?

We really don't know how much alcohol it takes to harm an unborn baby. At the lowest amounts, the risks from alcohol are probably very small; but as consumption increases, so do the risks. The more you drink, the greater the chances you take with the health of your unborn baby. There is no known safe level of alcohol, so if you avoid drinking altogether, there is no possibility of having a child with fetal alcohol syndrome or alcohol-related birth defects. The U.S. Surgeon General says: "The safest choice is not to drink at all during pregnancy, or if you are planning to get pregnant." In addition, women who breast feed should not drink alcoholic beverages until their babies are weaned., since the alcohol passes from the mother's milk to the baby.

Cigarette Smoking: The Major Cause of Low Birth Weight Babies

Low birth weight is the single most common cause of infant death and disease. Pregnant women who smoke are more likely than non-smokers to have low birth weight babies (weighing less than 5.5 pounds) and babies whose physical and intellectual growth is below normal. Smoking is also a major cause of miscarriages, complications during pregnancy, and premature deliveries.

The nicotine in cigarettes constricts the mother's blood vessels, reducing the amount of oxygen the baby receives. When you smoke, the nicotine passes through the placenta and into the baby's bloodstream, speeding up the heart rate and upsetting the respiratory system.

The good news is that the earlier you quit smoking, the better your chances are for delivering a normal weight baby. Even cutting down on smoking is beneficial- since the more you smoke the greater the chances your baby will be under weight.

Street Drugs: They're Not Worth the Risk

Marijuana, cocaine, heroin, and other narcotic drugs are dangerous for anyone to use. They can be particularly damaging for a pregnant woman and her unborn baby. If you use these drugs during pregnancy, you increase the risks of miscarriage, premature birth, and pregnancy complications. Exposure to these drugs also increases the newborn's risks for low birth weight, retarded growth, visual and coordination problems, and many serious medical problems that require intensive care. One of the most distressing effects of these powerful drugs is the severe withdrawal symptoms they produce in newborn babies. Infants exposed to these drugs are restless and jittery, experience tremors, disturbed sleeping and feeding patterns, have a high-pitched cry and are startled by even the slightest stimulation. These babies also have a very difficult time bonding with their mothers.

Researchers still have a great deal to learn about how street drugs, particularly crack and cocaine, affect newborn babies and the young children who have been exposed to them. Nonetheless, they present a clear and present danger to the health and well-being of both mother and child.

If you use street drugs, stop now. Get help if you need it from your doctor, your nurse, or someone close to you. They can help you or tell you how to get help. Stay strong and healthy now that you're pregnant, make the decision to stay strong and healthy for your sake and your baby's. Choose a personal lifestyle that promotes your own health and well being, so you can improve your chances of having a strong and healthy baby.

• Eat nutritious foods that nourish both you and your baby.
• Be sure to have regular checkups during your pregnancy.
• Get regular exercise to feel fit and strong.
• Avoid alcoholic beverages. Switch to fruit juices, water, or other nonalcoholic beverages at meals, at parties, and when relaxing with friends.
• Quit smoking, or if that's not possible right now, cut down as much as you can. Smoke only half of each cigarette and figure out ways to postpone or delay lighting up. Check with your doctor before using any over-the-counter or prescription medicines during your pregnancy or while breast feeding. Even aspirin or cold medicines may harm you or your baby.
• Don't use marijuana, cocaine, or any other street drugs. Try new ways to relieve stress and anxiety that won't harm you or your baby.
• Finally, don't forget to reward yourself each time you overcome an urge for a drink, a cigarette, or the temptation to use other drugs. Do something special for yourself or for the baby. Or, do something you enjoy, like relaxing in the tub. Keep reminding yourself how good you feel and how much safer your baby is by not being exposed to alcohol, tobacco, and other drugs.

Coping with Stress and Anxiety

Pregnancy changes your life in some important ways, and you're bound to feel some stress and discomfort during this period. Some women experience more anxiety and depression than usual during pregnancy. There may be times when a cigarette, a few drinks, or some other drug might seem like a solution for dealing with whatever is troubling you. At those times, stop and try to think of other ways you might handle your feelings.

First, try to understand what is bothering you. Then try to figure out what specific action you can take to improve the situation and to feel better. Would it help to talk about your feelings with someone close to you? Or to write your feelings down? How about relieving stress by taking a brisk walk, listening to some relaxing music, or getting involved with an activity you enjoy? Have you ever tried deep breathing, meditation, or other relaxation techniques? Many women find these steps to be effective alternatives to alcohol, tobacco, or other drug use.

Getting Help

If you smoke, or think you may have an alcohol or other drug problem, discuss it with your doctor or someone close to you. You can also find help through a variety of local groups, including:

American Lung Association
National Council on Alcoholism and Drug Dependence March of Dimes
Alcoholics or Narcotics Anonymous
Women for Sobriety
A mental health agency or a women's center.

These groups often have special programs for pregnant women and most of these organizations are listed in your telephone book. For more information about alcohol, cigarettes, and other drugs and pregnancy, write: CSAP's National Clearinghouse for Alcohol and Drug Information P.O. Box 2345 Rockville, MD 20847-2345 or call: (800) 729-6686.

   U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
   Public Health Service
   Substance and Mental Health Services Administration
   Center for Substance Abuse Prevention
   DHHS Publication No. (ADM) 92-1915, Printed 1992, reprinted 1995