Women who are pregnant or trying to conceive but are struggling with substance abuse are placing not only their own mental and physical health in jeopardy but that of the unborn child.
This is according to Dr Bavi Vythilingum, a specialist psychiatrist practising at Netcare Akeso Kenilworth, who said alcohol and other addictive substances can have devastating impacts on a growing foetus, with potentially serious developmental consequences.
“Studies indicate that women who use alcohol during pregnancy are often suffering from mental health conditions such as depression, anxiety or other disorders,” she said.
“Women who are unable to stop drinking, even though they know it can be harmful to their baby, are in desperate need of mental healthcare so that they can better look after themselves as well as the infant for whom they will soon be responsible.
“Different addictive substances all have specific effects during pregnancy, but broadly speaking, they all negatively affect the growth of the foetus, increasing the risks for pre-term labour and low birth weight.
“Alcohol, in particular, can result in babies being born with foetal alcohol syndrome and other foetal alcohol spectrum disorders, which are extremely common in South Africa but often go undiagnosed,” she said.
“Foetal alcohol syndrome includes characteristic facial abnormalities, such as small eyes and a smooth ridge between the upper lip and nose, as well as a number of other internal and external physical deformities.
“It furthermore affects brain and central nervous system development and results in numerous behavioural issues as the child grows up.”
Dr Vythilingum said other foetal alcohol spectrum disorders might have less obvious physical symptoms but can have a devastating impact on the mental development of a child.
“These children will have some degree of intellectual impairment and resulting behavioural issues, such as poor attention span and an inability to concentrate, difficulties with learning language, mathematical challenges and generally being behind in their schooling.
“This will often be coupled with impulsive behaviour and poor judgment, which as they grow older can lead them to experiencing mental illness as well as possibly entering a life of crime.
“Often experiencing anxiety and depression, they may turn to substance abuse themselves as a way of trying to cope with the harsh realities of their life.
“There is an alarming lack of awareness around foetal alcohol spectrum disorders, which are heavily undiagnosed in South Africa.
This is despite the fact that these disorders are a leading cause of generational substance abuse in many communities.
“There is also a misconception that substance use during pregnancy is restricted to lower-income groups but it exists at all levels of society.
“The resulting disorders are entirely preventable and dependant on the mother’s choices.” It is never too late to stop the use of alcohol and other substances during pregnancy, because foetal brain growth continues throughout the gestational period.
The sooner you stop, the better your child’s chances of healthy development will be. “By the same token, women who are actively trying to fall pregnant should not use alcohol, smoke or use other addictive substances, such as recreational drugs, at all,” she said.
“Women generally may only find out that they are pregnant around six to eight weeks in, and you may unwittingly expose your unborn child during this period.
“Pregnancy can be a stressful time and may be all the more difficult for those who have pre-existing mental health concerns, such as depression and anxiety.
“It is of the utmost importance for your well-being and that of your child to focus on replacing alcohol and other substances with healthy mechanisms to help you cope, such as breathing exercises, walking or pregnancy yoga.
“It is also essential to seek professional mental help if you find you are unable to stop using substances during your pregnancy, so you can begin to address the underlying concerns and find practical and effective ways of managing these.
“The development of your baby, as well as your own mental state, will be further supported by healthy food choices and maintaining a balanced diet rich in fruits, vegetables, lean protein and fibre, while avoiding processed foods as far as possible.
“Many people who use alcohol to destress are unaware that it increases stress levels over time. “By exercising and supplying your body with good nutrition, you are giving yourself and your baby a stronger foundation.
“Finally, women who need to take certain medications should not stop taking these upon discovering that they are pregnant but should discuss which medicines are safe with their treating doctor.
“Many antidepressants are safe during pregnancy, and it is important to keep a handle on your mental health rather than to turn to alcohol and other substances,” she said.
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