Substance use

Substance use

Women who use substances during pregnancy often have adverse childhood experiences or traumatic experiences (138). One study found that antenatal depression was associated with a (139):

  • 1.2 times greater risk of drinking alcohol during pregnancy.
  • 1.7 times greater risk of smoking during pregnancy.
  • 2.6 times greater risk of using cannabis during pregnancy.
  • Another study found that people with a history of unmet mental health needs were 4.1 times more likely to use illicit drugs during pregnancy (140).

Substance use during the perinatal period is likely to impact infant mental health:

  • Drug use can disrupt parents’ ability to build strong relationships with their infant (141). Co-occurring substance use and mental health need in parents is associated with high rates of adverse infant outcomes (142) and can place infants at a greater risk of neglect and abuse (143).
  • It has been estimated that 32.4 in 1000 people in the UK have foetal alcohol spectrum disorder (FASD) (144). Children and adults living with FASD are at higher risk of mental health conditions (145,146).
  • There is some evidence to suggest that prenatal alcohol exposure is associated with mental health problems in children at low to moderate levels of alcohol use (147).

Local population

Parental substance use was covered in chapter 2 of the needs assessment. Nationally 1 in 12 women under 20 accessing drug and alcohol services is either pregnant or a mother (47).


47. Public Health England. Making the Case for Preconception Care: Planning and preparation for pregnancy to improve maternal and child health outcomes [Internet]. 2018 [cited 2023 Mar 2]. Available from:
139. Brown RA, Dakkak H, Gilliland J, Seabrook JA. Predictors of drug use during pregnancy: The relative effects of socioeconomic, demographic, and mental health risk factors. J Neonatal Perinatal Med. 2019;12(2).
140. Pfeifer LR, Haile ZT. Unmet Mental Health Care Needs and Illicit Drug Use During Pregnancy. J Addict Med. 2021;15(3).
141. Suchman NE, McMahon TJ, Slade A, Luthar SS. How early bonding, depression, illicit drug use, and perceived support work together to influence drug-dependent mothers’ caregiving. American Journal of Orthopsychiatry. 2005;75(3).
142. Royal College of Psychiatrists. Perinatal Maternal Mental Health Services: Recommendations for Provision of Services for Childbearing Women [Internet]. 2021 [cited 2023 Mar 24]. Available from:—perinatal-mental-heath-services.pdf?Status=Master&sfvrsn=82b10d7e_4
143. Bromfield L, Lamont A, Parker R, Horsfall B. Issues for the safety and wellbeing of children in families with multiple and complex problems. Vol. 33, NCPC Issues. 2010.
144. Lange S, Probst C, Gmel G, Rehm J, Burd L, Popova S. Global prevalence of fetal alcohol spectrum disorder among children and youth: A systematic review and meta-analysis. JAMA Pediatr. 2017;171(10).
145. Pei J, Denys K, Hughes J, Rasmussen C. Mental health issues in fetal alcohol spectrum disorder. Vol. 20, Journal of Mental Health. 2011.
146. Kodituwakku PW. Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Vol. 31, Neuroscience and Biobehavioral Reviews. 2007.
147. Easey KE, Dyer ML, Timpson NJ, Munafò MR. Prenatal alcohol exposure and offspring mental health: A systematic review. Drug Alcohol Depend. 2019;197.