The incidence ofsubstance abuse among pregnant women is believed to have increased almost threefold over the past five years, with tik being the drug of choice, according to the provincial Department of Health.
Although the province has the lowest perinatal mortality rate, infant mortality rate, under-five mortality rate and maternal mortality rate in South Africa, substance abuse during pregnancy is high among expecting mothers.
With the Western Cape expecting an estimated 102 000 births in the 2016/2017 financial year, the provincial Health and Social Development Department, launched the First 1 000 Days project to promote the well-being of mothers and their babies and emphasise the crucial importance the first three years of a child’s life play in their development.
Health MEC Dr Nomafrench Mbombo said the programme will seek to counter the impact of substance abuse. In the Western Cape, tobacco, alcohol and methamphetamine (tik) are the top three substances used by expecting mothers.
“Alcohol and methamphetamine are the most prevalent among mothers who haven’t attended antenatal programmes, which is essential for all expecting mothers to attend during their pregnancy,” Dr Mbombo said.
Samantha (not her real name) is an 18-year-old mother from Woodstock. Her two-year-old son suffered birth deformities because she used tik while she was pregnant.
She shared her story with the Southern Mail in the hope it would stop other mothers ending up where she did.
“I never really had a family myself. My mother died when I was young and my father was in and out of prison, but it was always just me and my brothers. When my father was home, we were always in the company of these strange looking people who were almost always getting high in our house,” she said, stroking her son’s hair.
Samantha dropped out of school at 14 to chase after her high school crush, but it was a relationship that had a bad ending written all over it.
“He was much older than me, and I so badly wanted somebody in my life, as I did not have many friends too as our house was not really regarded as a happy home. We did really love each other, but things quickly got worse between us, especially after I broke the news I was pregnant,” she said.
Samantha moved in with her 19-year old boyfriend. He was on drugs, and soon she was too. Tik came to rule her life. “I used to stand at 2am in the morning asking for money to buy drugs. Sometimes I had to be out getting money to feed both our habits. I never ever did any sex work though, but I still put myself at major risk.”
Samantha was 16 when she fell pregnant. By then the drug had her in its grip.
“I would literally wake up and take a hit. I went the whole day, only when we had money, just taking hits. People who walked into the house all used the drug, and they were always bringing the drug into the house,” Samantha said.
She even skipped clinic visits to get high, and when a doctor spoke to her about her drug problem and how it could affect her child, all she could think of was where she would get her next fix.
“I was young and it did not hit me that I am carrying another life inside of me. It never hit me that the person inside of me was being damaged. I never meant to hurt him,” she said, a tear rolling down her face.
Reality hit home when her son was born with a right lung and kidneys which had not fully formed. Samantha realised her drug use was to blame. With her baby in her arms, Samantha decided then and there that she needed to kick her drug habit. She checked into rehab after leaving the hospital.
“I got rid of everything, not only my habit.
“I sent my boyfriend packing, my father returned to jail and my brothers are all part of gangs today. I distanced myself from it all, because the only thing that had meaning to me was my son and the only thing that bothered me was that I woke up too late,” Samantha said.
“I owe it to him. I did this to him and I will forever hold this against myself,” she said from her tiny rented bedroom.
In 2011, the leading cause of deaths among children under the age of five years was neonatal, with prematurity being the leading cause – followed by pneumonia, diarrhoea and injuries.
Dr Mbombo said substance abuse increased the risk of premature delivery, birth deformities and stillbirth. “Using substances during pregnancy can cause irreversible abnormalities of the baby’s heart, brain, kidneys and digestive system. Babies are also born with severe withdrawal symptoms after birth, making them cry incessantly and have difficulty with breathing, sucking and swallowing,” she said.
Mowbray Maternity Hospital is the largest dedicated maternity hospital in South Africa with more than 10 000 deliveries annually.
It reports seeing a growing number of women with complicated pregnancies and other health conditions, such as hypertension (high blood pressure), TB and HIV/Aids.
Dr Mbombo said smoking (tobacco) had an equally detrimental impact on the health of a developing foetus. “There is no ‘safe’ level of smoking while pregnant,” she stressed.
Dr Mbombo encouraged mothers to seek guidance and assistance should they have a substance abuse problem.
“Enquire at your local clinic about information on the First 1000 Days campaign. Helpful information is also available in the Road to Health Booklet (RTHB). We are here to help you and your baby, but we require your full support,” said Dr Mbombo.