Drug information
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Heroin is one in a group of drugs known as opiates. It is a depressant which slows down the activity of the central nervous system. Repeated use of heroin causes physical and psychological dependence.
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Heroin use is often associated with use of other drugs including tobacco and alcohol.
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Effects on pregnancy
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Using heroin while pregnant can harm your unborn baby.
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When you are pregnant and use heroin it is passed on to your baby via the placenta. If you experience withdrawal symptoms, so does your baby. Withdrawal creates an unstable environment for your baby and increases the risk of spontaneous miscarriage, premature labour and stillbirth.
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If you continue to use heroin, the amount you need to prevent withdrawal may increase as your pregnancy progresses.
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Sharing injecting equipment increases the risk contracting blood borne viruses such as Hepatitis C and HIV for both mother and baby.
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As heroin is a street drug, quality can be unreliable. It may be cut with unknown substances which may be harmful to you and your pregnancy. The strength or quality of heroin may not be consistent, resulting in overdose or death.
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Heroin and other opiates are not associated with physical abnormalities in babies, however ongoing heroin use may result in your baby being born smaller than expected, earlier than expected and he/she may have other health problems. However, what the heroin is 'cut' with, the additives, may be harmful to the unborn.
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Detox from heroin is not recommended in pregnancy because of the associated risks of withdrawal, miscarriage etc.
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Counselling in pregnancy
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If you are using heroin during pregnancy, there are drug treatment options available. Counselling can assist you to explore the options available and make an informed choice. Counselling can also help you explore associated issues related to your heroin and/or other opiate use. It can also provide you with harm minimisation strategies to reduce the risks of drug use to yourself and your baby.
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There are negative effects of heroin and other opiate use including dependency; distorted coordination, concentration and judgement; feelings of hostility and unpredictable behaviour. These effects may have an impact on your ability to effectively parent.
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Counselling can assist you to explore how heroin is affecting your responsibilities and responses as a parent. With this increased awareness, positive steps can be put in place to protect your child from your drug use.
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Pregnancy care
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Pregnancy care is important to ensure you are healthy and your baby is growing well. This will involve regular visits to your midwife or doctor to meet your individual requirements. Routine investigations such as blood tests, ultrasounds and a health screen will be included in your care.
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It is recommended that you are commenced on a methadone stabilisation program as soon as possible after pregnancy has been confirmed if you are experiencing withdrawal symptoms when you don't use heroin.If you are already on bupnorphine and using heroin, please refer to bupnorphine information.
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Nausea, vomiting and constipation commonly occur in pregnancy and when you use heroin. Speak with your midwife or doctor - they may refer you to a dietitian.
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You may need dietary supplements such as iron, multivitamins and calcium throughout your pregnancy. All women should take folate before conceiving and for at least the first three months of their pregnancy.
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Eating well during pregnancy and whilst you are breastfeeding is important for the health of you and your baby. Speak with your health worker about ways to minimise the harm to yourself and your pregnancy when you are using heroin.
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Breastfeeding
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Heroin passes into breast milk in small amounts and can affect your baby. If you continue to use heroin, breast feeding is not recommended.
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To safely breast feed your baby, it is important you seek assistance from a health worker to cease using.
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If you are injecting heroin you are at greater risk of contracting Hepatitis C, HIV and other blood borne viruses.
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After using heroin, it is not safe for you to care for or breastfeed your baby. You may accidentally smother your baby as you will not be alert to your baby's needs.
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Infant Development
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With the exception of alcohol, it is very difficult to prove that drug use in pregnancy results in any permanent long term behavioral or learning problems in children as they grow up.
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Most research suggests that if a child is raised in a caring and supportive family environment, they will do as well at school as any other child in similiar circumstances.
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The combined use of alcohol and drugs, particularly cannabis and cocaine, is an especially high risk situation.
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Care of infant
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Following birth, your baby will be seen by a paediatric doctor to ensure he/she is well.
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Babies of women who have been regularly using opiates during their pregnancy are at risk of developing a Neonatal Abstinence Syndrome (NAS) or infant withdrawal.
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NAS is a condition which can be treated safely and effectively. It is not possible to reliably predict before birth which babies may develop NAS. NAS does not appear to be related to the mother's dose of heroin.
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Most babies will show some signs of withdrawal. This can vary from mild withdrawal symptoms which can be managed by supportive care (cuddling, quiet environment and using pacifiers) to more marked symptoms which require medication. All babies will remain in hospital for a 7 day period and be observed for signs of NAS.
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For information on assessment and treatment of NAS, see fact sheet on Neonatal Abstinence Syndrome.
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If you use heroin or other opiates, co-sleeping with your baby is not recommended. It is also not recommended that you use drugs and/or alcohol as it can make you sleep more deeply. You may be less aware of where your baby is in your bed and less responsive to your baby's needs. Please refer to SIDS information below.
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It is important that you provide a smoke free environment for your baby at all times.
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Sudden Infant Death Syndrome
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SIDS is the sudden unexpected death of a baby from no known cause. It is the most common cause of death for infants in Australia between the ages of one and twelve months. The risk of SIDS is greater if you smoke or use drugs and alcohol during pregnancy or after your baby is born.
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For more information, speak with your midwife or doctor or contact SIDS and Kids by phoning, for the cost of a local call, 1300 308 307 or log on to www.sidsandkids.org .
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Other services
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DirectLine is part of Turning Point's statewide telephone service network, providing 24-hour, seven day counselling, information and referral to alcohol and drug treatment and support services throughout Victoria. DirectLine is a free, anonymous and confidential service.
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Phone: 1800 888 236
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