RESEARCHER WARNS OF DRUG ABUSE IN PREGNANCY

The ideal picture of motherhood is a woman who will do anything to protect her child. Unfortunately, when addictive drugs come into the picture, ideals go out the window, and many women continue using drugs, alcohol and tobacco during pregnancy.

"If a pregnant woman who is truly addicted is given a choice between drugs and her baby, she'll pick drugs," said Dr. Ira Chasnoff, one of the nation's leading researchers in the field of maternal drug abuse during pregnancy, who spoke Wednesday at a prenatal substance abuse training session held in Cape Girardeau. "It goes against the grain of our idea of motherhood, but that's the reality of addition."

If a health-care provider can spot the substance abuse and get the pregnant woman into an effective treatment program, it can improve the outcome for both mother and baby, Chasnoff said.

The purpose of the training session was to alert area physicians, nurses, social workers and others who work with pregnant women about the effects of substance abuse on the fetus, the importance of educating pregnant women about and screening them for substance abuse and helping abusers get into treatment.

The National Institute on Drug Abuse estimates that more than 1 million children per year are exposed to alcohol and, or illicit substances during gestation. Christy Mothershead with Bootheel Healthy Start in Sikeston, one of the training sponsors, said there are no figures on how large the problem is in Southeast Missouri because currently health-care providers don't consistently screen for substance abuse.

One of the reasons for having the training is to increase the amount of screening done in this area, Mothershead said.

But even without firm numbers, Mothershead said it is believed prenatal substance abuse is a problem in this area.

"We think there is a problem because of the number of learning problems showing up in schools," she said. "A possible explanation is exposure to drugs, alcohol and tobacco in utero."

Learning problems are just one of many problems that can plague children whose mothers abused drugs while they were pregnant, said Chasnoff, president of the Children's Research Triangle, a non-profit organization that studies the effects of prenatal substance abuse.

Chasnoff said that when he talks about drugs he includes both illegal drugs and improperly used prescription drugs, alcohol and tobacco. He also emphasized that drugs can cause problems whether it is long-term use or occasional use and throughout the pregnancy.

"There is no safe time during pregnancy to use drugs," Chasnoff said.

About 25 percent of babies born to women who used drugs or alcohol have medical problems that include low birth weight, prematurity, small brain size, failure to thrive, apnea and changes in body structure, including limb and organ deformities.

"Those are problems you can see," Chasnoff said. "But the majority of babies born to drug-abusing women have significant neurobehavioral problems that are not as recognizable until the child gets older."

These include depression, anxiety, thought problems, social problems, distractibility, attention problems, aggressive behavior and impulsive behavior.

Cognitively, these children may have normal IQs and may even be extremely bright, Chasnoff said. But they have problems regulating their behavior.

"Prenatal exposure to drugs produces changes in brain chemistry that predict behavior problems," Chasnoff said.

Chasnoff said many health-care providers are often reluctant to ask pregnant women about substance abuse. They often fear that they might be sued about asking, which Chasnoff said has never happened; that women won't be truthful, which Chasnoff said can be overcome with the right approach; or that treatment won't work, which Chasnoff said is untrue if the treatment is aimed at women.

Chasnoff addressed such issues at a physician symposium hosted Wednesday night by Healthy Start, the Missouri Bureau of Maternal Child Health and St. Francis Medical Center.

Janine Jepson, an education and training manager at Bootheel Healthy Start, said the training is continuing today when physicians and representatives from treatment centers will come together to discuss strategies for a screening system, identifying at-risk women and disseminating information on what treatment programs exist in this area.

"It helps to have a strategic plan for the community on how to coordinate services and get past the barriers of getting these women into treatment," Chasnoff said.