This sheet is about exposure to MDMA in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is MDMA?

3,4 methylenedioxymethamphetamine (MDMA) is a drug that can cause an altered state of mind (hallucinations / delusions). Other names for MDMA include Molly, ecstasy, E, X, XTC, and Mandy. MDMA can be taken by mouth as a pill or capsule or snorted / inhaled as a powder.

If you have been using MDMA, please seek help right away. Treatment is available to help you stop using MDMA. Talk with your healthcare providers; they are there to help you.

I am taking MDMA, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

People eliminate drugs at different rates. In healthy adults, it takes up to 4 days, on average, for most of the MDMA to be gone from the body.

I take MDMA. Can it make it harder for me to get pregnant?

It is not known if MDMA can make it harder to get pregnant.

Does taking MDMA increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if MDMA increases the chance for miscarriage.

Does taking MDMA increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Based on the studies reviewed, it is not known if MDMA increases the chance for birth defects above the background risk. One small study reported an increase in heart defects and / or club foot (foot points downward and inward). However, it is not known if the MDMA or other factors caused the increase in birth defects.

Does taking MDMA in pregnancy increase the chance of other pregnancy-related problems?

Based on the studies reviewed, it is not known if MDMA can cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking MDMA in pregnancy affect future behavior or learning for the child?

Based on the studies reviewed, it is not known if MDMA increases the chance for behavior or learning issues. A study of twenty-eight pregnancies exposed to MDMA reported infants showed a delay in development at four months old. Another study followed a small group of children exposed 1 month before pregnancy and in the first and second trimesters. The study suggested that babies exposed to MDMA might be delayed in their motor development up to 2 years of age. However, the people who were pregnant also reported exposure to alcohol and other drugs. This makes it hard to know if the MDMA, other exposures, or other factors caused these delays.

Breastfeeding while taking MDMA:

Breastfeeding while using MDMA is not recommended. MDMA passes into breast milk. Amphetamine drugs (like MDMA) are found at higher levels in breastmilk than in the blood stream. If MDMA has already been taken, it has been recommended to express and discard breast milk for 48 hours. If you suspect the baby has any symptoms (fever, seizures, rapid heartbeat, eyes rolling, looking upwards for a period of time), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

If a male takes MDMA, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?

Studies have not been done to see if MDMA could affect male fertility or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Selected References:

• Barenys M. 2009. Chronic exposure to MDMA (ecstasy) increases DNA damage in sperm and alters testes histopathology in male rats. Toxicol Lett 191:40-46 [PubMed: 19683041]
• Barneys M, et al. 2020. Developmental neurotoxicity of MDMA. A systematic literature review summarized in a putative adverse outcome pathway. Nurotoxicology 78:209-241. [PubMed: 31812710]
• Committee on Drugs, American Academy of Pediatrics. 2001. The transfer of drugs and other chemicals into human milk. Pediatrics 108:776-89. [PubMed: 11533352]
• Cooper AJ & Egleston CV. 1997. Accidental ingestión of Ecstasy by a toddler: Unusual cause for convulsion in a febrile child. J Accid Emerg Med 14(3):183-184. [PMC free article: PMC1342919] [PubMed: 9193992]
• Draper ES, et al. 2008. Recreacional drug use. A major risk factor for gastroschisis? Am J Epidemiol 167(4):485-491. [PubMed: 18063593]
• Fríguls B, et al. 2010. A comprehensive review of assay methods to determine drugs in breast milk and the safety of breastfeeding when taking drugs. Anal Bioanal Chem397:1157–1179. [PubMed: 20386886]
• Kolbrich EA, Goodwin RS, Gorelick DA, Hayes RJ, Stein EA, Huestis MA. 2008. Plasma pharmacokinetics of 3,4-methylenedioxymethamphetamine after controlled oral administration to young adults. Ther Drug Monit. Jun;30(3):320-32. [PMC free article: PMC2663855] [PubMed: 18520604]
• Marcela C, et al. 2019. Stimulant use in pregnancy – An under-recognized epidemic among pregnant women. Clin Obstet 62(1):168-184. [PMC free article: PMC6438363] [PubMed: 30601144]
• McElhatton P, et al. 1999. Congenital anomalies after prenatal ecstasy exposure. Lancet 354:1441-2. [PubMed: 10543673]
• Parrott A, et al. 2014. MDMA and heightened cortisol: a neurohormonal perspective on the pregnancy outcomes of mothers used 'Ecstasy' during pregnancy. Hum Psychopharmacol 29(1):1-7. [PMC free article: PMC10187755] [PubMed: 24424703]
• Plessinger M, 1998. Prenatal exposure to amphetamines. Risks and adverse outcomes in pregnancy. Obstet Gynecol Clin North Am 25:119-38. [PubMed: 9547763]
• Singer LT, et al. 2012. Neurobehavioral outcomes of infants exposed to MDMA (Ecstasy) and other recreational drugs during pregnancy. Neurotoxicol Teratol 34(3):303-10. [PMC free article: PMC3367027] [PubMed: 22387807]
• Singer L. et al 2012. One-year outcomes of prenatal exposure to MDMA and other recreational drugs. Pediatrics 130(3): 407–413. [PMC free article: PMC3428761] [PubMed: 22908109]
• Singer LT, et al. 2015. Developmental outcomes of 3,4-methylenedioxymethamphetamine (ecstasy)-exposed infants in the UK Hum Psychopharmacol 30(4): 290-294. [PMC free article: PMC5107979] [PubMed: 26216565]
• Singer LT, et al. 2016. Motor delays in MDMA (ecstasy) exposed infants persist to 2 years. Neurotoxicol Teratol 54: 22-28. [PMC free article: PMC4789145] [PubMed: 26806601]
• Smid MC, et al. 2019. Stimulant use in pregnancy: An under-recognized epidemic among pregnant women. Clin Obstet Gynecol 62(1):168-184. [PMC free article: PMC6438363] [PubMed: 30601144]
• van Tonningen-van Driel MM, et al. 1999. [Pregnancy outcome after ecstasy use; 43 cases followed by the Teratology Information Service of the National Institute for Public Health and Environment (RIVM)]. Ned Tijdschr Geneeskd 143(1):27-31. [PubMed: 10086095]
• Wouldes TA, Lester BM. 2019. Stimulants: How big is the problem and what are the effects of prenatal exposure? Semin Fetal Neonatal Med 24(2):155-160. [PubMed: 30803902]

“OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.