Substance Use and Pregnancy: Care Instructions

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When you are pregnant, what you eat, drink, or take into your body may affect you and your pregnancy.

It is safest to avoid using alcohol and drugs if you are pregnant or could become pregnant. Even a little alcohol or drug use could be harmful. Smoking can also cause problems.

Some examples of drugs are marijuana, meth, cocaine, and opioids like heroin. Drug use also includes the misuse of prescription or over-the-counter medicines.

If you smoke, vape, or use alcohol or drugs, try to quit. If you can't quit, cut back as much as you can. Talk to your doctor if you need help quitting or cutting back.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Find a doctor or midwife you can trust. It's important to feel safe and respected when talking about any issue, including substance use.
  • If you use alcohol, marijuana, or other drugs, quit or cut back as much as you can. It's safest not to use them at all. Talk to your doctor if you need help decreasing your use.
  • If you smoke or vape, quit. If you can't quit, cut back as much as you can. Try not to let others smoke around you. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Take medicines as prescribed by your doctor. Your doctor may prescribe medicines to help you quit or to help you get through withdrawal symptoms.
  • Find out about treatment programs in your area. Contact the national Substance Abuse and Mental Health Services Administration (SAMHSA) help line at 1-800-662-HELP (4357) or online at to learn more.
  • Think about counseling. A counselor can help you find healthy ways to manage emotions and make changes in your life. You may get counseling in a group or one-on-one.
  • Ask for help from people you trust, such as friends or family. They could go with you to your doctor appointments. And they can support your lifestyle changes, such as avoiding places where you used to drink alcohol or use drugs.
  • Join a support group. Look for a group that is kind and helpful about substance use and pregnancy. Groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) may work for you.
  • If you or someone you know uses opioids, cocaine, meth, or other drugs, keep a naloxone (Narcan) kit with you at all times. Make sure that your family and friends know you have a kit. Tell them how and when to use it.
  • Follow healthy habits. Eat a variety of foods and limit caffeine. Take a daily vitamin with folic acid. Try to get enough rest. Also get regular exercise if your doctor says it's okay. For example, you could try walking or swimming.
  • Be sure to go to all doctor appointments. When you are pregnant and during the months after delivery, regular checkups help the doctor find and treat problems early.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have serious withdrawal symptoms, such as confusion and severe trembling.
  • You feel you cannot stop from hurting yourself or someone else.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

  • Call the Suicide and Crisis Lifeline at 988.
  • Call 1-800-273-TALK (1-800-273-8255).
  • Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to for more information or to chat online.

If you have a naloxone rescue kit, use it after you call 911.

Call your doctor now or seek immediate medical care if:

  • You have blackouts, which are times when you are awake but forget what occurs while drinking. This is not the same as passing out.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have a relapse.
  • You need help with drug or alcohol problems.
  • You have any problems with your medicine.

Where can you learn more?

Go to

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.