How Does Drug Use During Pregnancy Affect a Fetus?

Courtesy of Godoy Medical Forensic

 

Causes of Still-Born Births

The incidence of still-born births in the United States is 1 in every 160 pregnancies. The diagnosis of fetal demise is usually completed via ultrasound to confirm the absence of the fetal heart beat. Autopsy is generally recommended, along with diagnostic testing in an attempt to provide causation.

Common causes of fetal demise are:

• Birth defects;
• Placental issues;
• Poor fetal growth;
• Infection;
• Chronic health conditions of the mother;
• Umbilical cord accidents; and
• Trauma.

Not all causes can be identified on autopsy, nor are all causes determined. In a recent study, African-American females were found to have a two-fold increased risk of still-born births without any correlating cause. External causes are difficult to definitively correlate with fetal demise, but there are higher incidences of still birth associated with drug use. For example, cigarette smoking is the most common identifiable preventable cause of stillbirth with an odds ratio of 1.6.

Drug Effects on the Fetus

The consumption of many substances can cross the placental barrier and affect the fetus. Not only is this true for everyday substances we consume throughout the day, but for legal and illegal drugs, as well. The consumption of illicit drugs during pregnancy is harmful to the mother and to the fetus. Drugs such as marijuana, cocaine, and heroin will cross the placental barrier, and may affect the growth and development of the unborn child. Illicit drugs can cause miscarriage, low birth weights, premature labor, placental abruption from the uterus, and fetal demise.

Legal Implications

In some states, the criminal justice system is attempting to prosecute mothers of still-born babies if the child resulted positive for illicit drugs on autopsy. In 2007, a young Mississippi woman was indicted by a grand jury for “depraved heart murder” which is defined as an act that results from the gross negligence of an individual. The indictment reported she had “unlawfully, willingly, and feloniously” caused the death of her child from smoking crack during her pregnancy. Although, at birth, it was noted the umbilical cord was wrapped around the baby’s neck. One article on the case can be viewed here.

The controversy in that case is whether her drug use caused or contributed to the death of the unborn child. In truth, there are no individuals that can say for certain which was cause of death as both are correlated with fetal demise and both have resulted in a viable and even healthy child outcome. For certain, using illicit drugs during pregnancy is detrimental to the child.

It has long been discussed if the unborn child had, or has, any rights. In some states, such as Alabama, the Supreme Court has determined the definition of a “child” would include the unborn fetus. In other states, such as Tennessee, women that abuse drugs while pregnant could be criminally charged for harm done to their babies. This holds ramifications for everyone involved. New definitions will need to be put in place regarding what constitutes harm,gestational age qualifications, and a clarification of when harm is permissible (e.g. narcotics are commonly used during labor to ease the pain of the mother).

Disclaimer: Heightened emotions arise when discussing the rights of women and what they are permitted to do with their body versus the rights of children before they are born. This blog post is in no way a stance related to either side, but simply a commentary on a rising issue in the criminal system.