Pregnancy

If you are using opioids and think you may be pregnant, you can take steps to increase your baby’s chances of getting a healthy start:

  1. Avoid other substances, including alcohol and cigarettes.
  2. Get good prenatal care as early in the pregnancy as possible.
  3. Begin treatment for opioid use disorder.

Frequently, pregnant women who are using do not have the social support they need. They are often judged harshly and subjected to discrimination. Many pregnant women who try to stop using relapse again and again. They may try to get off opioids in an effort to do the best thing for their baby, but are not able to stick with it. This cycle can be very dangerous for the baby.

Abrupt withdrawal from opioids during pregnancy can be risky and MAT is recommended. Most states have facilities that specialize in treating pregnant women and families. If you call your state substance abuse service agency, they can tell you where to get help.

Pregnant women are granted priority admission to treatment by federal mandate. Most programs for women offer family-based treatment so they can bring their children with them. Learn more about what women should know about pregnancy, substance use, and MAT.

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Pregnancy and MAT

Many women who become pregnant while using opioids make immediate plans to quit. This is a good instinct. Studies find that women who use substances during pregnancy have more early births, deliver babies with lower birth rates, and have more problems during labor and delivery.

However, it is risky to go off opioids too quickly during pregnancy. When a pregnant woman uses opioids, they cross over into the bloodstream of the developing fetus and affect the baby’s system. If the mother quits cold turkey, the baby also experiences withdrawal symptoms. This can result in sudden abortion, early birth, and other dangerous complications.

Methadone has been used for a number of years to safely treat opioid use disorder during pregnancy, and has been widely researched. There is no known permanent harm to babies born to mothers treated with methadone during pregnancy. It controls withdrawal symptoms and helps stabilize heart rate, blood pressure, and other maternal and fetal functions. Pregnant women treated with methadone are three times more likely to remain in treatment (CSAT, 2009).

However, methadone also gets into the baby’s system. Shortly after birth, most babies born to mothers treated with methadone, experience temporary withdrawal symptoms such as fussiness or shaking. This is called neonatal abstinence syndrome (NAS). These symptoms are monitored in the hospital. About 50 percent of the time, NAS symptoms require special treatment that may include medications and longer stays in the hospital before infants can be discharged.

Buprenorphine is another treatment option for pregnant women. Although there are fewer long-term studies available on buprenorphine treatment during pregnancy, research has shown it is safe. It also effectively controls withdrawal symptoms and stabilizes maternal and fetal functions. A number of studies on buprenorphine and pregnancy have consistently shown that withdrawal symptoms are milder for infants born to mothers treated with buprenorphine. They are less likely to require treatment with medications and more likely to have shorter hospital stays than infants born to mothers treated with methadone.

Decisions about the right course of treatment are best made by each woman, with the help of a doctor experienced in treating pregnant women, who can explain the risks and benefits of each medication.

  • Some women have strong feelings about treatment with medications during pregnancy and may wish to withdraw from opioids. It is important they find a doctor or program that specializes in working with recovering women during in pregnancy. Experienced providers can supervise a safe withdrawal and make recommendations that are best for the health of mom and baby.
  • Pregnant women treated with buprenorphine are prescribed the single drug formula that contains buprenorphine only. Compounds that contain both buprenorphine and naloxone are not recommended for use during pregnancy or while breastfeeding, since naloxone has not been tested on pregnant women, and its effects on the developing fetus are unknown.
Female

I want to do the best I can for my baby. What medications are safest during pregnancy?