The Bottom Line

Women should call their HCP anytime they have questions regarding any aspect of their physical, social, emotional, and mental health during pregnancy.

HCPs can provide the resources or referrals necessary to help women and their families experience a healthy pregnancy and a healthy new family member.

As a reminder, under U.S. federal law, medical information is private, and women have the right to speak to their HCP alone, without a partner or family member.

For victims of domestic violence, sexual assault, or reproductive coercion, there are safe, secure, and discreet resources available that can be either in person, online, through the phone, or through text message.

If women are not comfortable with these methods, they should speak to their HCP alone, or any other close and trusted individual who can help the woman get the safety and resources she needs.

If women wish to stop smoking, drinking alcohol, or using recreational drugs during pregnancy, there are also many resources to help them quit; women can also use these resources before they become pregnant.

Pregnant women can also receive mental health support that can provide an invaluable benefit. The management, treatment, and prevention of depression, severe anxiety, and other behavioral disorders can help women have healthier pregnancies, avoid complications, and have a much easier and more enjoyable postpartum experience.

Women who are thinking about harming either themselves or the baby need to call 911 for immediate and emergent help, or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) | TTY: 1-800-799-4889

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Background

Many women need more specialized support during pregnancy to help them achieve the healthiest pregnancy possible, which includes resources for their mental, social, and emotional health.

Women should never hesitate to ask their HCP or other trusted individual to help them find the support and resources necessary for any aspect of their health and family situation, especially as it relates to pregnancy.

Crisis Text Line

Crisis Text Line: Text “HELLO” to 741741. The Crisis Text hotline is available 24 hours a day, seven days a week throughout the United States. The Crisis Text Line serves anyone, in any type of crisis, connecting them with a crisis counselor who can provide support and information.

Domestic Violence, Sexual Assault, and Reproductive Coercion

If a pregnant woman has experienced domestic violence, sexual assault, or reproductive coercion, there are numerous resources available to obtain immediate, safe, and discreet medical attention or law enforcement assistance.

According to the American College of Obstetricians and Gynecologists (ACOG), reproductive coercion includes "behaviors and explicit attempts to impregnate a partner against her will, control outcomes of a pregnancy, coerce a partner to have unprotected sex, and interfere with contraceptive methods".

Women can:

The National Domestic Violence Hotline can help women create a safety plan and locate resources in their area, if available. Women can call them 24/7 at 1-800-799-7233 or chat live via their website.

Rape, Abuse and Incest National Network’s (RAINN) National Sexual Assault Hotline: Women can chat online with a trained member who can provide confidential crisis support. Women can also call the Hotline at 1-800-656-4673.

Women can also call the Office on Women's Health Sexual Assault HELPLINE at 1-800-994-9662 (9 a.m. — 6 p.m. ET, Monday — Friday)

National Sexual Violence Resource Center: Directory of resources by state for domestic violence and sexual assault survivors

Alcohol

For women who wish to stop drinking alcohol during pregnancy, but need help, they should immediately talk to their HCP about alcohol treatment programs and other support resources. Based on current knowledge regarding fetal development, how the fetal body and placenta process alcohol, and alcohol's effects during pregnancy on infants and children, no amount of alcohol can be considered safe during pregnancy (read Alcohol).

Women can also visit:

  • The National Council on Alcoholism and Drug Dependence (also called NCADD) website, or call 1- 800 622-2255. 

  • The Substance Abuse Treatment Facility Locator on the Substance Abuse and Mental Health Services Administration (also called SAMHSA) website or call 1-800 662-4357; helps individuals find drug and alcohol treatment programs in their area.

  • The Fetal Alcohol Syndrome Information Service has a bilingual website and telephone service that provides links to support groups, prevention projects, resource centers and experts on fetal alcohol syndrome and fetal alcohol effects in Canada. English website; French website; or telephone 1-800-559-4514.

  • Alcoholics Anonymous® (A.A.) is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. Locate an A.A. program.

  • Women can visit the National Organization on Fetal Alcohol Syndrome (NOFAS) or call 800–66–NOFAS (66327)

  • Drinkline is the national alcohol helpline in the United Kingdom: If women are worried about their drinking, they can call this free helpline, in complete confidence; 0300 123 1110 (weekdays 9 am to 8 pm, or weekends 11 am to 4 pm)

  • NOFAS-UK (National Organisation for Foetal Alcohol Syndrome-UK)

Smoking

Pregnant women, and women trying to get pregnant, should talk to their HCP about options to help them quit smoking. There are several approved management techniques that can help them quit.

Women should note that e-cigarettes are not a “healthier” alternative to tobacco smoking as they contain numerous chemicals, flavoring components, and oils, in addition to nicotine. Recent research is only just beginning to identify the harmful effects of e-vapor and its flavoring components (read Vaping).

Resources:

Anxiety and Depression

Women who are suffering with anxiety and depression, along with feelings of intense worry, concern, helplessness, or even suicide, should call their HCP immediately or use one of the resources below. HCPs can help provide women the resources and support they need, and recommend a mental health care professional who can further assist.

Women should call 911 if they believe they may hurt themselves or their baby.

Women who are thinking about harming either themselves or their baby need to call 911 for immediate and emergent help.

They can also call the National Suicide Prevention Lifeline: at 1-800-273-TALK (8255) | TTY: 1-800-799-4889; women can visit the their website and talk to a trained, confidential crisis counselor 24 hours a day, 7 days a week – for ANY mental health or substance use concern.

Substance Abuse and Mental Health Services Administration's National Helpline: 1-800-662-HELP (4357) | TTY: 1-800-487-4889; women can call this National Helpline for free, confidential, 24/7 information and referrals to local mental health and substance use disorder treatment facilities, support groups, and community-based organizations.

Office on Women's Health Helpline: Call the HELPLINE: at 1-800-994-9662 9 a.m. — 6 p.m. ET, Monday — Friday; women should also consider reading their Depression Fact Sheet

National Network of Depression Centers: According to their website, the National Network of Depression Centers (NNDC) develops and fosters connections among members to use the power of our network to advance scientific discovery, and to provide stigma free, evidence-based care to patients with depressive and bipolar illnesses.

Postpartum Support International: This organization seeks to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum. Women can call 1-800-944-4PPD (4773) for answers to questions and information on resources; or text 503-894-9453 (971-420-0294 for Spanish).

National Alliance on Mental Illness: NAMI is a mental health organization dedicated to building better lives for the millions of Americans affected by mental illness; helpline: 1-800-950-NAMI (6264)

Additional resources:

Drug Addiction

It is critically important women stop using drugs during pregnancy, and ideally, before pregnancy. However, recovery can be incredibly difficult; fortunately, women have a lot of resources to help them achieve a drug-free pregnancy. Women should call their HCP for support before becoming pregnant, or immediately upon learning they are pregnant.

According to their website, SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. 

Treatment Approaches for Drug Addiction (National Institute on Drug Abuse): explains many available treatment options

American Society of Addition Medicine Patient Resources (ASAM): According to their website, ASAM is committed to improving access to high-quality, evidence-based addiction prevention and treatment through their national advocacy efforts.

What do I look for in a treatment center? (National Institute on Drug Abuse)

Drug & Alcohol Rehab Centers for Pregnant Women (AmericanAddictionCenters.org): According their website, American Addiction Centers is the leading provider for addiction treatment nationwide, specializing in evidence based treatment and mental health care.

Women can also look for a treatment center online at https://findtreatment.gov/ by simply entering a zip code.

Eating Disorder

Women who experienced an eating disorder prior to pregnancy (but are in recovery) or who are experiencing an eating disorder during pregnancy, should call their HCP. Friendly increased or additional monitoring or advanced support regarding nutrition, fetal development, and mental health support may be necessary to support the mother during her pregnancy.

The National Eating Disorders Association (NEDA) is the largest nonprofit organization dedicated to supporting individuals and families affected by eating disorders. NEDA supports individuals and families affected by eating disorders, and serves as a catalyst for prevention, cures and access to quality care.

National Eating Disorders Collaboration Booklet on Eating Disorders and Pregnancy may also be helpful for women and their partners/families.

Health Insurance

Pregnancy and parenting can be expensive, especially without healthcare. This can cause some women and families a disheartening amount of stress and anxiety.

The Affordable Care Act (2010) made affordable health insurance available to more people. For health insurance information, women should visit the healthcare.gov Marketplace (Health coverage for women pregnant or planning to get pregnant).

Additionally:

Maternity care and childbirth are covered by Medicaid and Children’s Health Insurance Program (CHIP).

These state-based programs cover pregnant women and their children below certain income levels. Eligibility and benefits are different in each state. Income levels to qualify are different for Medicaid and CHIP.

Applications can be submitted for Medicaid or CHIP any time during the year, not just during Marketplace Open Enrollment. Women/families can apply 2 ways: Directly through their state agency, or by filling out a Marketplace application. Women should click on the links above for more information.

Action

Women should call their HCP anytime they have questions regarding any aspects of their physical, social, emotional, and mental health during pregnancy. HCPs can provide the resources or referrals necessary to help women and their families experience a healthy pregnancy and a healthy new family member.

References

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