Drug use in pregnancy: Hunting witches in the 21st century
By: Núria Calzada and Fernando Caudevilla (Dr. X) *
A young pregnant woman goes for her first check with the gynecologist accompanied by her partner wearing long dreadlocks. After a series of questions to elaborate on the medical history of the woman, it is time to ask about drug use.
-‐ Do you drink alcohol?
-‐ No, nothing.
-‐ Do you smoke?
-‐ Yes, 7
-‐8 cigarettes a day.
-‐ Try to stop smoking or at least reduce it to less than 5 cigarettes.
-‐ Yes, I try. But it is not easy
-‐ Any other stuff?
-‐ Other stuff? What do you mean?
-‐ Marihuana The young woman becomes surprised and denies it, although she smokes every once in a while to relax. The gynecologist had not insisted – surely had not even asked – if she had not been accompanied by his dreadlocked partner. The young woman, at the doctor’s insistence and afraid, says she smokes some puffs occasionally, without realizing that with this statement her ordeal would begin. Most healthcare providers allow for a glass or a sporadic cigarette, but when they hear the word marihuana, the situation takes another color. Assuming legal drugs like alcohol and tobacco are consumed during pregnancy does not lead to stigma, denial and blame against the mother arise when it comes to illegal drugs.
This is a real case, a woman around 30 years old that, after her confession, her worst nightmare began. What happens in such cases? According to the healthcare system (private or public) a protocol of monitoring and risky pregnancy control may be activated. Considered as such, many analyses, like urine tests, are realized to the mother in order to detect drug use. Whether the result is positive or not during pregnancy, other tests are also realized to the baby after a few months after birth. If the result is positive, i.e. if they find THC metabolites in the baby, they might keep the baby under observation for several days until the tests are negative. Additionally, other actions may be as well activated, like the monitoring of social services to the mother, ban breast-‐feed if the mother uses marihuana or, even in the most serious cases, removing the custody of the baby.
