Can you take benzodiazepines during pregnancy?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

You should avoid using benzodiazepines during pregnancy. Prenatal exposure to benzodiazepines is linked to increased preterm births, low birth weight, and respiratory depression in newborns. Pregnant mothers taking benzodiazepines face higher rates of cesarean delivery, potential withdrawal symptoms, and complications that may compromise maternal well-being.

According to a 2022 study, first-trimester benzodiazepine exposure is associated with a small but significant increased risk of congenital malformations. The study shows the absolute risk of heart defects at 65.3 per 1,000 pregnancies exposed to benzodiazepines.

If you’re currently taking benzodiazepines or considering them for pregnancy-related anxiety or insomnia, Ardu is ready with personalized support to guide you to safer treatment options. Contact our benzodiazepine rehabilitation program and take the first step toward a healthier pregnancy for you and your baby.

Are benzodiazepines safe during pregnancy?

Benzodiazepines enhance the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity. This produces calming, sedative effects that manage generalized anxiety disorders, panic attacks, and sleep disorders. Despite their effectiveness in reducing neurological excitation, relieving muscle tension, and regulating disrupted sleep patterns, these medications impede fetal development. Even with proper medical guidance, benzodiazepines carry risks of tolerance, dependence, and withdrawal—complications that become especially problematic during pregnancy.

Benzodiazepines cross the placental barrier and can accumulate in fetal tissues at concentrations higher than those detected in maternal blood. According to a 2022 review article, they bind to GABA receptors in the developing fetal central nervous system and may disrupt normal brain development and cell proliferation.

The risks of using benzodiazepines during pregnancy

Benzodiazepines can harm the fetus and mother during pregnancy.

Effects on fetal development and child outcomes

Benzodiazepines can cause several worrying problems for babies immediately after birth and as they grow up.

Birth defects: First-trimester exposure to benzodiazepines slightly increases the risk of major malformations, particularly congenital heart defects like septal defects. This risk becomes more pronounced with higher doses, which shows a clear dose-response relationship.
Floppy infant syndrome: Newborns exposed to benzodiazepines often display poor muscle tone, weak reflexes, and feeding difficulties. These nursing infants may require intensive care unit (ICU) admission due to respiratory depression and other adverse effects on their developing nervous system.
Respiratory depression: If taken near delivery, benzodiazepines can diminish the newborn’s respiratory drive, leading to dangerous breathing problems immediately after birth.
Withdrawal symptoms: Many newborns experience drug withdrawal 2–3 days post-birth, including tremors, excessive irritability, high-pitched crying, and sleep disturbances. These signs are often linked to the impact of maternal benzodiazepine exposure.
Prematurity effects: Benzodiazepine exposure increases the likelihood of preterm delivery. Premature babies often face feeding difficulties, trouble regulating body temperature, and a higher susceptibility to infections.
Developmental delays: Children exposed to benzodiazepines during pregnancy are at greater risk for cognitive and language delays in early childhood. Long-term effects include challenges with school readiness and academic performance.
Neurobehavioral issues: Benzo use during pregnancy is linked to emotional regulation difficulties and behavioral challenges in babies that may persist into school age. Jensen, et. al. found evidence of higher attention-deficit/hyperactivity disorder (ADHD) traits at age 5 and increased internalizing problems at ages 1.5 and 3 years in children with prenatal benzodiazepine exposure.

Maternal health concerns

Benzodiazepines risk maternal health throughout pregnancy, delivery, and postpartum.

Benzodiazepine use during pregnancy increases the likelihood of cesarean delivery by up to 60% according to a 2020 systematic meta-analysis. During labor, these medications can suppress the mother’s respiratory function and diminish her ability to effectively participate in the birthing process.
Women using benzodiazepines throughout pregnancy frequently develop tolerance. This physical dependence creates a challenging situation during the postpartum period, because discontinuation can trigger withdrawal symptoms. They often emerge during a time when new mothers are already adjusting to significant life changes.
For mothers who wish to breastfeed, benzodiazepine use presents difficult decisions. Many women are torn between managing their anxiety and the effects of medication on breastfeeding.
Pregnant women with anxiety disorders face a difficult balancing act. Untreated anxiety itself carries maternal health risks including hypertension, poor nutrition, and decreased self-care. Addressing these symptoms with medications such as benzodiazepines adds complexity to prenatal care planning. The uncertainty surrounding this decision becomes an additional source of stress.

If you or someone you love is struggling with long-term benzodiazepine use, getting professional support can make all the difference, especially during life’s most vulnerable moments.

Ardu’s medically supervised detox and rehab begin with deep compassion and clinical precision. If pregnancy, postpartum, or the stress of long-term benzo use has left you feeling overwhelmed, Ardu can help. Our expert care supports and empowers you to reclaim your life with strength and clarity.

Are benzodiazepines safe to use during labor?

Benzodiazepine use during labor can affect the mother and newborn due to placental transfer. Their use is associated with more adverse perinatal outcomes such as reduced Apgar scores, respiratory depression, and hypotonia (decreased muscle tone) in newborns.

These effects are mainly a result of the pharmacokinetic properties of these drugs, which can accumulate in the fetal bloodstream because they are fat-soluble and metabolize slowly in neonates.

A 2014 study presents a case where maternal temazepam (Restoril) use caused a newborn to experience life-threatening issues like apnea, bradycardia, and hypotonia. The baby required resuscitation and was later found to have dangerously high levels of temazepam in the system. This incident shows how even a small dose of benzodiazepine can cause severe problems for newborns.

Safer alternatives to benzodiazepines in pregnancy

During pregnancy, it’s important to manage anxiety, sleep problems, and other concerns for the well-being of ]the mother and baby. There are many safer alternatives for benzos that can address these concerns without putting the baby at risk.

Cognitive behavioral therapy (CBT) is an effective therapeutic approach for managing anxiety and stress. It helps individuals identify and change negative thought patterns and behaviors, leading to improved emotional regulation and relaxation.
Mindfulness techniques and meditation can help reduce stress, improve focus, and promote relaxation.
Regular physical activity, such as walking or prenatal yoga, can alleviate anxiety and improve sleep. Exercise releases endorphins, which are natural mood boosters. It also helps regulate sleep patterns.
Deep breathing exercises, progressive muscle relaxation, or guided imagery are effective at reducing stress and promoting relaxation, particularly in the evening to improve sleep quality.
A consistent sleep routine, avoiding caffeine late in the day, and creating a calm, quiet environment can improve sleep without medication.
Essential oils such as lavender and chamomile can reduce anxiety and promote better sleep. Aromatherapy can be used through diffusers, bath oils, or massage.
Talking with a counselor or joining a support group can provide emotional support during pregnancy. Connecting with others going through similar experiences can help alleviate feelings of isolation and anxiety.
Certain herbal teas, such as chamomile or lemon balm, are safe for most pregnancies and can have mild calming effects. Consult with a healthcare provider before using any herbal supplements during pregnancy.
Acupuncture is an effective treatment for managing anxiety and sleep problems. It involves inserting thin needles into specific points on the body, which may help restore balance and promote relaxation.
A balanced diet rich in nutrients, vitamins, and minerals can support mental and physical health. Omega-3 fatty acids, magnesium, and B vitamins, in particular, help with mood regulation and stress management.

If you’re struggling with benzodiazepine use during pregnancy or any other time, seek professional help with Ardu Recovery Center. Our benzodiazepine rehab services offer support and guidance to help you safely manage your recovery and enjoy a better outcome for you and your baby.

Reach out to our specialists today.

Ardu Recovery Center's Benzodiazepine Treatment Program

Navigating benzodiazepine use before, during, or after pregnancy requires specialized care and support. Our addiction experts understand the unique challenges women face with benzodiazepine dependence and provide comprehensive treatment options.

Our benzodiazepine rehabilitation program incorporates:

Medically supervised detoxification with specialized protocols for pregnant women.
Integrated mental health treatment addressing underlying anxiety or panic disorders.
Evidence-based therapies including CBT and dialectical behavioral therapy to address anxiety, depression, and emotional regulation issues.
Holistic addiction treatment approaches that support the whole person.
Family therapy to strengthen support systems during recovery.
Mindfulness-based therapy that builds sustainable coping skills.
Relapse prevention strategies tailored to women’s needs.

Our team of healthcare professionals brings expertise in addiction medicine and women’s health. At our women-oriented rehab center, we create individualized treatment plans that account for the physiological and emotional aspects of benzodiazepine dependence.

For pregnant women or those planning pregnancy, our specialists coordinate care with obstetricians to develop the safest approach for mother and baby. We emphasize treatment methods that support maternal well-being while minimizing risks to pregnancy.

Contact Ardu Recovery Center today to learn how our compassionate, science-based approach can support your journey toward freedom from benzodiazepine dependence.

Benzodiazepine pregnancy FAQ

What is the safest anxiety medication during pregnancy?

During pregnancy, medications for anxiety are not recommended because of the potential risks for maternal and neonatal outcomes. Holistic alternatives are the safest approach for managing anxiety and related disorders during pregnancy. Techniques such as cognitive-behavioral therapy (CBT), mindfulness, and relaxation exercises are effective and do not pose adverse pregnancy outcomes.

If medication becomes necessary, it should be prescribed and monitored by a healthcare professional, considering the safety of drugs during pregnancy and avoiding psychotropic drugs that could harm the developing baby.

Can a gynecologist prescribe Xanax?

A gynecologist can prescribe Xanax (alprazolam), but it is avoided during pregnancy due to the adverse pregnancy outcomes. Benzodiazepine-related drugs may lead to neonatal complications, including withdrawal symptoms in the infant and potential developmental issues.

If anxiety management becomes necessary during pregnancy, non-pharmacological treatments are preferred, such as therapy or relaxation techniques. There are safer alternatives with fewer risks to the fetus to consider. Exposure to psychotropic drugs, such as benzodiazepines, should always be evaluated with caution, especially during the first trimester of pregnancy, to minimize potential adverse effects on maternal and fetal health.

Is CBD safe during pregnancy?

Avoid taking cannabidiol (CBD) when pregnant. Because the research on its safety is limited, the potential risks CBD poses to fetal development may outweigh the benefits. Exposure to CBD during pregnancy, particularly in the first trimester, could have adverse outcomes on the developing fetus, including possible interference with brain development. As a result, pregnant women are advised to avoid CBD products and consult with their healthcare professionals before using any medications or supplements during pregnancy.

Do benzos affect fertility?

Benzodiazepines can impact fertility. Fogliano, et. al. suggest that long-term use of benzodiazepine-related drugs may interfere with hormone regulation, affecting menstrual periods and ovulation. Researchers also found that benzodiazepines “interfere with reproduction, affecting not only reproductive behavior but also male and female gametes.” In men, benzodiazepines may impact fertility by disrupting sperm production and quality, which may lower sperm count and reduce motility.

If you’re concerned about how benzodiazepines might affect your fertility, consult with a healthcare professional who can guide you through the potential risks and explore alternative treatments, especially if you’re planning for pregnancy.

Is benzodiazepine use during pregnancy teratogenic?

Benzodiazepine-related drug exposure during pregnancy is teratogenic, particularly in the first trimester, when fetal development is most vulnerable. Such exposure may increase the risk of congenital anomalies, including oral clefts and cardiac malformations, as well as other birth defects. Maternal benzodiazepine use during pregnancy can also lead to withdrawal symptoms in newborns, which may affect their health.

The potential teratogenic effects of benzodiazepine-related drug exposure need to be carefully considered in the context of each case. Healthcare professionals often conduct a thorough assessment and statistical analysis of the risks involved when prescribing medications during pregnancy.

What is floppy baby syndrome caused by benzodiazepines?

Floppy infant syndrome (or neonatal hypotonia) is a condition where a newborn experiences poor muscle tone and weakness as a result of exposure to benzodiazepines during pregnancy. This condition can arise when the mother uses these medications late in pregnancy or during labor. Symptoms of floppy baby syndrome include lethargy, respiratory difficulties, and poor muscle control. These symptoms typically improve over time as the drug clears from the newborn’s system.

Resources

Noh Y, Lee H, Choi A, Kwon JS, Choe SA, Chae J, Kim DS, Shin JY. First-trimester exposure to benzodiazepines and risk of congenital malformations in offspring: A population-based cohort study in South Korea. PLoS Med. 2022 Mar 2;19(3):e1003945. doi: 10.1371/journal.pmed.1003945. PMID: 35235572; PMCID: PMC8926183.

Xinchen Wang, Tianyang Zhang, Isabella Ekheden, Zheng Chang, Clara Hellner, Jan Hasselström, Nitya Jayaram-Lindström, Brian M D’Onofrio, Henrik Larsson, David Mataix-Cols, Anna Sidorchuk, Prenatal exposure to benzodiazepines and Z-drugs in humans and risk of adverse neurodevelopmental outcomes in offspring: A systematic review, Neuroscience & Biobehavioral Reviews, Volume 137, 2022, 104647, ISSN 0149-7634, https://doi.org/10.1016/j.neubiorev.2022.104647

Anne Grosbøl Jensen, Signe Schöllhammer Knudsen, Bodil Hammer Bech, Prenatal exposure to benzodiazepines and the development of the offspring – a systematic review, Neurotoxicology and Teratology, Volume 91, 2022, 107078, ISSN 0892-0362, https://doi.org/10.1016/j.ntt.2022.107078

Grigoriadis S, Graves L, Peer M, et al. Pregnancy and Delivery Outcomes Following Benzodiazepine Exposure: A Systematic Review and Meta-analysis. The Canadian Journal of Psychiatry. 2020;65(12):821-834. doi:10.1177/0706743720904860

Damen L, Visser DH, Sie SD, van Weissenbruch MM. Apparent Life-Threatening Event following Maternal Use of Temazepam during Labour. Case Rep Pediatr. 2014;2014:650605. doi: 10.1155/2014/650605. Epub 2014 Jun 15. PMID: 25024861; PMCID: PMC4082877.

Fogliano C, Carotenuto R, Cirino P, Panzuto R, Ciaravolo M, Simoniello P, Sgariglia I, Motta CM, Avallone B. Benzodiazepine Interference with Fertility and Embryo Development: A Preliminary Survey in the Sea Urchin Paracentrotus lividus. Int J Mol Sci. 2024 Feb 6;25(4):1969. doi: 10.3390/ijms25041969. PMID: 38396658; PMCID: PMC10888474.