Support for Families Impacted by Drug and Alcohol Use

Support for physical and mental health

Pregnancy causes many changes to your body and emotions. These can affect people in different ways.
Physical changes can include tiredness, feeling like you want to throw up, constipation, and other symptoms. Pregnancy can affect people’s tolerance for substances. It may lead to cravings and other feelings of withdrawal.
You might have more mood swings and big feelings – this is normal!

One of the most important things you can do for yourself and your baby is to go to your prenatal care visits. Have open conversations about your substance use with a doctor (OB/GYN), midwife, nurse practitioner, or physician’s assistant.
Stigma around substance use in pregnancy is real. Try to find a provider you trust to provide nonjudgmental care. This will help you openly discuss your substance use and access helpful resources and support.
Your provider will check your blood pressure, do a physical exam, measure your belly, and listen to the baby's heart. The provider may also offer medications or therapies for your substance use, or other addiction care.

To better care for you and your baby, people will ask about past or current substance use. This includes alcohol, marijuana, tobacco, opioids, cocaine, and other drugs.
You may be asked to do a urine or blood test to help guide the care of you and/or your baby. The provider should ask in a nonjudgmental, standardized way. They should allow you to ask questions about how the information will be used. Legally, you have the right to say "no" if you are uncomfortable. But this may affect your ability to receive treatment in some places.

Depending on the substance(s) you used during pregnancy, care for your baby might differ. Talk to your provider about how your substance use could impact the baby.
Some babies born to parents taking opioids (including medications like buprenorphine or methadone) may have withdrawal symptoms, like irritability or diarrhea, in the first few weeks. Your care team will monitor this. Doctors may call this neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS).
NAS/NOWS symptoms can be treated but may mean that the baby needs to stay in the hospital for a longer period of time. The baby may need medications or extra care from the provider team. In all cases, the birthing parent and other caregivers have an important role in providing skin-to-skin contact, feeding the baby, and holding the baby.

Because of Pennsylvania state law, if your baby shows withdrawal symptoms requiring medical treatment, your healthcare team may call ChildLine to make a “notification” and offer you a Plan of Safe Care. This is the same as a report of child abuse or neglect
A Plan of Safe Care lists resources and services that may be helpful for you and your baby. It is different from a safety plan. It can connect you with resources, like substance use treatment and support for your baby.

You can say no to the Plan of Safe Care if you aren’t interested, but the notification may still be made to follow the law.
ChildLine and DHS will see the notification and follow up on related referrals. If they have concerns about your child’s safety, they may open an investigation/case. This can be related to a parent’s substance use or not.
For information on preparing for a possible ChildLine notification and/or investigation, you or your provider can call the Community Legal Services Family Hotline at 215-981-3765. They offer free legal help Monday through Friday, 9 am to 5 pm.

New parents sometimes feel overwhelmed, sad, anxious, or exhausted – this is normal! These feelings often go away on their own. If they worsen or affect your ability to care for yourself or your baby, you may have postpartum depression or anxiety.
During this time, people with a history of drug or alcohol use have a high risk of returning to use and stopping treatment too soon.
Talk to someone you trust about how you feel. This could be a family member, friend, partner, or health care provider. Help is available!

Breastmilk is good for both you and your baby! It can be given to your baby through breastfeeding or from a bottle. Breastfeeding can lead to stronger bonding with your baby and can decrease the baby’s withdrawal symptoms.
In most cases, you are encouraged to breastfeed your baby.
Non-prescribed drugs, like heroin and fentanyl, could harm you and the baby. If you or your providers are worried about the use of non-prescribed substances, your healthcare team can help create a plan for feeding your baby.

No matter how you choose to feed your baby, you are encouraged to reach out for support before or after your baby is born!
After your baby is born, ask your healthcare team for support with breastfeeding, pumping, and other help while you are in the hospital.
Other resources are available, like non-judgmental home visiting, advocates, doulas, and mental health supports.