Substance Use During Pregnancy

At a glance

Learn about substance use (including opioids, marijuana, tobacco, and alcohol) during pregnancy. Also, find out about resources for health professionals and CDC activities to address this important health topic.


Opioids are a class of drugs that are used to manage pain, but they have serious risks, such as addiction. Opioids can be prescription or illicit. Prescription opioids may be prescribed by doctors to manage moderate to severe pain. Heroin is an illicit opioid. Fentanyl is a prescription opioid but has also been made illegally.

Need help for a substance use disorder?

Talk to your health care provider or call Substance Abuse and Mental Health Services Administration's (SAMHSA) National Helpline at 1-800-662-HELP. You can also go to SAMHSA's Behavioral Health Treatment Services Locator.

Opioid use disorder is a problematic pattern of opioid use. It can result in health problems, disability, or failure to meet major responsibilities at work, school or home. Along with counseling and behavioral therapy, medications may be used to treat opioid use disorder.

Opioid use among pregnant women is a significant public health concern. From 2010 to 2017, the number of women with opioid-related diagnoses at delivery hospitalization increased by 131%. Opioid use disorder during pregnancy has been linked with serious negative health outcomes. These include preterm birth, stillbirth, maternal mortality, and neonatal abstinence syndrome.

If you're pregnant or trying to become pregnant, talk to your provider. Talk to your provider before starting or stopping prescription opioids or opioid use disorder medications. This will help you understand all of the risks and make the safest choice. To learn more, visit Treatment for Opioid Use Disorder Before, During, and After Pregnancy.

CDC activities to address opioid use during pregnancy

CDC is taking specific actions to prevent opioid use disorder among pregnant women and women who could become pregnant. CDC is also supporting activities to make sure women with opioid use disorder get proper treatment.


Some research shows that marijuana use during pregnancy is linked to health concerns. These include high use of other substances that may impact pregnancy and infant health such as tobacco. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. Consistent with guidance from the American College of Obstetricians and Gynecologists, CDC discourages using marijuana during pregnancy. If you're using marijuana and are pregnant or are planning to become pregnant, talk to your health care provider.

For more information, see Cannabis and Pregnancy. Also, visit The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (2017).

CDC activities to address marijuana use during pregnancy

CDC's Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. DRH presents state and national estimates of marijuana use among pregnant women. This helps clinicians and public health professionals better understand the prevalence of marijuana use. CDC also works to better understand the association between marijuana use while pregnant with birth outcomes and postpartum health. View a recent publication: Frequency of cannabis use during pregnancy and adverse infant outcomes, by cigarette smoking status.


Smoking during pregnancy increases the risk of health problems for developing babies. These include preterm birth, low birth weight, and birth defects of the mouth and lip. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome (SIDS).

Additionally, e-cigarettes and other tobacco products containing nicotine are not safe during pregnancy. Nicotine is a health danger for pregnant women and can damage a developing baby's brain and lungs. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby. Learn more about e-cigarettes and pregnancy.

Quitting tobacco can be hard, but it is possible. Quitting smoking is an important way you can protect your health and the health of your baby. Quitting early or before pregnancy is best, but it's never too late to quit smoking. Your doctor can play an important role in helping you quit.

You can also call 1-800-QUIT-NOW (1-800-784-8669) for free support. Quitline coaches can answer questions, help you develop a quit plan, and provide support. For tips and advice to quit smoking, visit How to Quit and Pregnancy, Motherhood, and Smoking.

For more information, visit Smoking, Pregnancy, and Babies and Electronic Cigarettes from the Office on Smoking and Health. For providers, see ACOG Committee Opinion: Smoking Cessation During Pregnancy.

CDC activities to address tobacco use during pregnancy

To learn about CDC activities, visit Tips From Former Smokers® (Tips®) from the Office on Smoking and Health. The Tips® campaign features information about how smoking and secondhand smoke affects specific groups. This includes pregnant women or women planning to have a baby.

Maternal and Child Health Indicators provides the latest Pregnancy Risk Assessment Monitoring data on cigarette smoking before, during, and after pregnancy.


There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. There is also no safe time during pregnancy to drink. All types of alcohol are equally harmful, including all wines and beer. If a woman is drinking alcohol during pregnancy, it is never too late to stop. If you are pregnant or trying to get pregnant and cannot stop drinking, get help.

Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person exposed to alcohol before birth. FASDs are preventable if a baby is not exposed to alcohol before birth. Learn more about FASDs and the health impacts of alcohol use during pregnancy.

Contact your health care provider, local Alcoholics Anonymous, or local alcohol treatment center. Learn more at Alcohol Use During Pregnancy from the Division of Birth Defects and Infant Disorders.

CDC activities to address alcohol use during pregnancy

To learn about other CDC activities, visit the FASD homepage from the National Center on Birth Defects and Developmental Disabilities.