Pregnancy and Opioids
For individuals who have just discovered they are pregnant and currently using opioids, they should be aware of the possible risks of use during pregnancy and follow the steps listed below:
- Talk to your provider and discuss all risks and benefits of continuing any medication during pregnancy.
- Do not stop taking the medication without discussing with your provider. The risks associated with stopping opioid medication are dangerous and can have serious side-effects to the expecting mother and fetus.
- Connection to medication-assisted treatment (MAT) during pregnancy is essential and recommended as best practice for the care of pregnant women with opioid use disorders. Under medical supervision, methadone or buprenorphine can reduce the risk of pregnancy complications. These medications are safe for the baby and also allow the mother-to-be to focus on prenatal care and her opioid use disorder treatment and recovery program.
- For soon to be mothers who are diagnosed with an opioid use disorder, they will also need to be connected to treatment services that to address her physical, psychological, emotional and social issues in addition to her opioid use.
*There are currently no adequate or controlled studies on whether naltrexone (Vivitrol) is safe during pregnancy. Studies suggest that if a woman is already stable on Vivitrol, she should continue treatment so as not to destabilize recovery.
Babies exposed to prescription opioids or heroin prenatally can have temporary withdrawal or abstinence symptoms called Neonatal Abstinence Syndrome (NAS). These withdrawal symptoms may also occur in babies whose mothers take methadone or buprenorphine, although it's important to note that not all babies experience NAS.
Breastfeeding is safe and should be encouraged for women who are taking methadone or buprenorphine and has been shown to reduce the severity of NAS. It also has many other benefits for mothers and babies. However, breastfeeding is not safe for women with HIV, who are taking certain medicines (check with the doctor) or who have relapsed and are actively using substances.
After Delivery – Postpartum Period
The postpartum period can be a stressful time for women and especially women in recovery. New mothers should continue substance use disorder treatment; attend parenting support programs and counseling/relapse prevention programs. The new mother should not make a decision to stop her methadone or buprenorphine too quickly or too soon because this increases the risk of relapse. It is important for her to discuss decisions about her medication with her doctors.