| PRENATAL ABUSE: EFFECTS OF DRUG EXPOSURE BEFORE AND AFTER DELIVERY |
| Pregnancy is an important time in life for both the mother and the unborn child. The health of the mother and the things that the mother does while pregnant, have both direct and indirect effects on the development of a child. Research on the outcomes of drug-exposed children reported that drug use during pregnancy can cause many side effects for the mother and the baby before and after delivery. This includes premature birth, maternal weight loss, nutritional deficits, and increased exposure to many transmitted diseases. Many reports have shown that prenatal cocaine use can lead to an array of fetal, newborn, and child development problems (Cocaine and Pregnancy). Since the mid-1980�s it is estimated that 1 � 1.5 million babies have been born in the United States to cocaine dependent mothers. Cocaine is a very dangerous drug and the babies that are exposed to it face many health problems before and after birth, ranging from subtle effects to life threatening effects. However, because most pregnant mothers who use cocaine also use other drugs such as, alcohol, tobacco, heroin, and marijuana, it is difficult to determine the health problems caused solely by cocaine (Cocaine Use During Pregnancy, Dec 2002). Some studies have shown that babies, who are regularly exposed to cocaine, tend to score lower than unexposed babies on tests given at birth to assess the newborn�s physical condition and overall responsiveness. Cocaine use may also cause the placenta to pull away from the wall of the uterus before labor begins. This is called placental abruption, which can cause very heavy bleeding and can be fatal to the mother and the baby (Cocaine Use During Pregnancy Dec 2002). Barth (2001) stated that prenatal exposure to drugs and alcohol negatively affect birth outcomes through primary and secondary effects. Prematurity, low birth weight, smaller head circumference, and shorter infant length have all been directly associated with prenatal drug and alcohol use. Barth (2001), also concluded that problems with motor skills, IQ, fussiness, and consolability, and attention span are associated with prenatal cocaine exposure. The Maternal Lifestyles Study, the most comprehensive study to date of drug-exposed newborns, also found �subtle� but significant cognitive effects that cause long-term educational and mental health service use. �Political and legal responses to the perceived hazards of prenatal cocaine use may cause more harm than good� (Cocaine and Pregnancy, n.d.). Although prenatal drug exposure has captured a great deal of public attention, prenatal exposure to illicit drugs is more widespread and has perhaps an even more serious impact than previously thought. �The National Institute on Drug Abuse estimates that sixty percent of women of childbearing age consume alcoholic beverages despite the fact that alcohol consumption during pregnancy is implicated in a wide range of birth defects and developmental disabilities, including mental retardation, physical abnormalities, and visual and auditory impairments� (Effects of Prenatal Exposure� n.d.). Children exposed parentally to drugs have fostered great concern about their behavioral development. �The development of children who are exposed parentally to drugs is of special concern to those in child welfare because of the large number of children in care who come from drug-involved families� (Franck, Ellen J. Jan 1996). According to Drug Use During Pregnancy (n.d.) mothers taking illegal drugs during pregnancy have high risks including, blood and heart infections, skin infections, greater risks of sexually transmitted diseases, poor appetite, trouble sleeping at night, premature labor, sudden bleeding, and have a hard time trying to make decisions or plans. After the baby has been born the mother tends to have trouble being a parent, has a hard time coping with the new baby�s needs, greater chance of feeling depressed after the baby has been born, and withdrawal symptoms. Unborn babies have effects of greater severity including, low birth weight, heart problems, mental retardation, death, defects on the face and body, slow growth and development, fetal alcohol syndrome, and early delivery problems. Overall and within race/ethnic groups, rates of use during pregnancy of marijuana, cocaine, and cigarettes often were significantly higher for women who were not married, had a low socio-economic status, low prenatal care, currently unemployed, had less than sixteen years of formal education, or relied on public aid for payment of the hospital bills ((National Pregnancy and Health Survey, op.cit., p.3). Black women had significantly higher rates than White women for use of any illicit drug and cocaine, and significantly higher rates than Hispanic women for use of any illicit drug (Effects of Prenatal Exposure� n.d.). According to Ellen J. Franck (Jan 1996), �women of color are far more likely than Caucasians to be reported to authorities for drug use.� The rates of crack cocaine use in women ages twenty-five to twenty-nine and older were significantly higher than the rate for those under the age of twenty-five (Effects of Prenatal Exposure� n.d.). Some statistics show that, �of 2092 women, 1142 (55%) were African American, 736 (35%) were non-Hispanic White, and 214 (10%) were of other ethnicities. They ranged from 20 to 39 years of age, and all the women were Medicaid eligible, 1304 (62%) had children, and 1634 (78%) were high school graduates. One thousand seventy-one women (51%) began prenatal care in the first trimester of pregnancy, 792 (38%) began in the second, and 229 (11%) began in the third (Martin, Sandra L; English, Kathleen T Clark, Katheryn Anderson et al. July 1996). Among infants exposed in utero to drugs, those placed in foster homes differed tremendously from those not placed in family foster homes. The children placed will have been more frequently abused than those that are not placed. Death rates among substance exposed infants will be higher than death rates for infants in the general population. Exposure of an infant to illicit substances can be established by the use of appropriate laboratory tests that can confirm the presence of heroin, opiates, marijuana, PCP, or cocaine by using the urine of an infant. To determine the infants that receive this lab work, the infant must be exhibiting withdrawal symptoms such as irritability, poor feedings, tremors, or seizures (Juades, Paula Kienberger; Ekwo, Edem E. July 1997). |