What is Perinatal Substance Abuse Program (PSAP)?

Learn more about perinatal substance abuse programs (PSAPs) and whether it is the appropriate treatment option for you.

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What is a Perinatal Substance Abuse Program?

Drug addiction and abuse are never safe, but it can prove especially dangerous if you are struggling with addiction while you are pregnant. Perinatal substance abuse endangers both your life and the life of your unborn child. Fortunately, there are numerous ways to treat substance abuse during pregnancy and improve the quality of life for you and your child.

A perinatal substance abuse program, or PSAP, can be used to help women cope with substance abuse and dependency during pregnancy.

Perinatal Defined

The term “perinatal” refers to the few weeks immediately before and after birth.

Why is Perinatal Substance Abuse a Problem?

Perinatal substance abuse can have several adverse effects on both the mother and child. These can include:

  • Fetal alcohol syndrome in cases of alcohol abuse
  • Low birth weight, placental abruption, and increased infant mortality if smoking during pregnancy
  • Low birth weight, preterm delivery, cognitive impairment, and placental abruption if abusing other illicit drugs

Pathophysiology of Perinatal Substance Abuse

Pathophysiology refers to the disordered thought processes that are often a side effect of perinatal substance abuse. It can be the result of various types of drug abuse, including opium abuse.

What are Exogenous Opioids?T

Exogenous opioids are opioids that come from external sources. Examples include morphine, heroin, and fentanyl. They differ from endogenous opioids that are produced in the brain.1

The Opioid Epidemic

Despite increased awareness about the dangers of opioid abuse, the opioid epidemic continues to rage all over the world and is a major factor in prenatal substance exposure.

One study looked at a sample of thirty women who had a substance abuse problem during their pregnancy. Twelve women in the group admitted to using prescription opioid analgesics such as Vicodin, Percocet, and Fentanyl.

Infants who are exposed to opioids exhibit symptoms of Neonatal Abstinence Syndrome (NAS) which include hyperirritability and dysfunctions in the nervous system, respiratory syndrome, and gastrointestinal tract.2

Rapid Drug Withdrawal During Pregnancy Increases Risk

It is vital to treat prenatal drug use, but rapid withdrawal can be unhealthy for the baby. It can cause diarrhea, fever, irritability, seizures, and difficulty feeding. It can also lead to:3
  • Fetal growth restriction: This occurs in a substance abuse pregnancy when the baby does not grow as expected in the womb. The baby will be born with a low birth weight, and their body will be weak. This will make it difficult for them to gain weight and fight infections.
  • Placental abruption: Placental abruption involves the placenta partially or fully separating from the inner wall of the uterus before delivery. It can decrease or block the baby’s nutrient supply. It can also cause the mother to bleed heavily.4
  • Preterm labor and fetal death: Perinatal substance abuse may cause the baby to be born before the gestational period is complete. This can lead to problems associated with low birth weight. It can also lead to fetal death.
Because rapid withdrawal is dangerous for the baby, pregnant women are advised to wean off drugs gradually. Methadone is often used to treat perinatal opioid disorders.

Long-Term Effects Related to Prenatal Drug Exposure

Babies with mothers that exhibit substance abuse during pregnancy may struggle in every phase of life due to permanent damage done while in utero. Some of these struggles are detailed below.


Perinatal substance abuse can cause a baby to be born small due to fetal growth restriction or preterm labor. Babies that are born underweight will have trouble gaining weight, which makes them weak and susceptible to infections. It can also cause them to have developmental issues later in life.


Prenatal drug use can cause increased secretion of stress hormones that can negatively affect the baby’s behavior. Children will often show signs of hyper irritability. Behavior problems may stay with them later in life and affect the way they function in school.

Cognition/Executive Functioning

Drug addiction and pregnancy are a dangerous combination for a baby’s cognition and executive functioning. Prenatal substance exposure can cause long-lasting damage in the brain’s structure and function. It can lead to learning disabilities, mental health disorders, and limited neural adaptations.

Predisposed to Own Drug Use

Part of the long-term effects of prenatal drug exposure includes a predisposition to drug use. A baby may choose to emulate their mother if she is a substance abuse user. They may also turn to drugs to self-medicate problems caused by substance use in pregnancy, such as mental health disorders.

Treatment of Perinatal Substance Abuse at Soledad House

Perinatal substance abuse isn’t easy to deal with, but fortunately, perinatal treatment services are available. Possible treatment options are explained below.


Detoxification involves ridding your body of illicit substances. Withdrawal symptoms will occur as the body adapts to being without drugs in its system. A perinatal substance abuse program will provide you with medical supervision that will keep you as comfortable as possible and ensure relapse doesn’t occur.

Inpatient and Outpatient Rehabilitation

Patients have the option of doing inpatient or outpatient rehab. Inpatient rehab is beneficial as it means patients are in treatment 24/7. The staff can oversee their treatment and make adjustments as needed. However, outpatient rehab may be a better option for mothers as it allows them to split their time between recovery and caring for their baby.


Therapies are a vital part of treating substance abuse during pregnancy. Therapy can address the addiction and its underlying cause in order to help people develop healthy coping mechanisms that replace the need to use.

Contact Soledad House Today

Soledad House provides personalized care for women. Our team of highly-trained mental health professionals will work with you to develop the most appropriate treatment plan to ensure your success in recovery.

Perinatal substance abuse is not healthy for you or your child. Reach out to Soledad House for the help you need today.