Opioids and Pregnancy

Opiate use in pregnancy has increased dramatically over the past decade and now represents a major public health problem. More women are using prescription opioids, illegal opioids, and opioid substitution therapy.

These drugs are associated with numerous obstetrical complications including intrauterine growth restriction, placental abruption, preterm delivery, oligohydramnios, stillbirth, and maternal death. Neonatal complications are also significant, such as an increased risk of mortality as well as neonatal abstinence syndrome (NAS).

Using opioids during pregnancy may cause problems for your baby, including:


This is when a baby dies in the womb before 20 weeks of pregnancy.

Preterm labor and premature birth.

Preterm labor is labor that starts too early, before 37 weeks of pregnancy. Preterm labor can lead to premature birth. This is when your baby is born before 37 weeks of pregnancy. Babies born early may have more health problems at birth and later in life than babies born full term.

Birth Defects

Birth defects, including heart defects and spina bifida. Birth defects are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. Spina bifida is the most common neural tube defect (also called NTD). Neural tube defects are birth defects of the brain and spinal cord.

Low Birth Weight

Low birthweight (also called LBW). This is when a baby is born weighing less than 5 pounds, 8 ounces. Opiod use can also contribute to fetal growth restriction (also called growth-restricted, small for gestational age and small for date). This means a baby doesn’t gain the weight they should before birth.

Neonatal abstinence syndrome (NAS).

NAS is when a baby is exposed to a drug in the womb before birth and goes through withdrawal from the drug after birth. NAS is most often caused when a woman takes opioids during pregnancy.

NAS can cause serious problems for a baby, such as being small for gestational age and having breathing problems. Even if you use an opioid exactly as your health care provider tells you to, it may cause NAS in your baby.

I’ve been prescribed an opioid – what should I do?

It is absolutely essential that you tell your prenatal care provider about any opioid you take, even if it’s prescribed to you by another health care provider. If another health care provider prescribes you an opioid, make sure they know you’re pregnant.

If you’re not pregnant and you’re using opioids, use effective birth control until you’re ready to get pregnant. This can help prevent complications when you do get pregnant.

Is it safe to suddenly quit taking opioids during pregnancy?

No. Quitting suddenly (also called going cold turkey) during pregnancy can cause severe problems for you and your baby. If you’re pregnant and taking opioids, don’t quit without talking to your health care provider. Quitting opioids suddenly may increase your risk of having a placental abruption.

A placental abruption is serious condition in which the placenta separates from the wall of the uterus (womb) before birth. It can separate partially or completely. Placental abruption can cause heavy bleeding that can be life-threatening to mom and can lead to premature birth. The placenta grows in your uterus and supplies your baby with food and oxygen through the umbilical cord.

Quitting opioids suddenly while pregnant can also cause preterm labor and premature birth, growth problems in your baby and even stillbirth. This is the death of a baby in the womb after 20 weeks of pregnancy.

If you’re breastfeeding, is it safe to take opioids?

Breastfeeding is good for both you and your baby. It helps you bond with your baby, and your breast milk helps build your baby’s immunity to protect her from infections. If you baby has NAS, breastfeeding may help make her withdrawal less severe so she needs less medicine and can leave the hospital sooner.

If you’re using prescription opioids for pain relief with your provider’s supervision, you can breastfeed depending on the medicine you take. Some opioids can cause life-threatening problems for your baby. Make sure the provider who prescribes you the opioid knows you’re breastfeeding, and take the medicine exactly as our provider tells you to.

How FRBH Can Help

Four Rivers Behavioral Health (FRBH) offers a variety of substance abuse programs for both adults and adolescents. Their Specialized Addiction Services offers additional substance abuse treatment programs.

An Intensive Substance Abuse Program is available for those involved in the court system, have a history of legal problems related to substance abuse or have failed at other treatment efforts. Specifically, they offer Hazelden Betty Ford’s COR-12 Program as part of the many substance abuse treatment options available to their clients.

COR is the acronym used for Comprehensive Opioid Response and the 12 signifies the importance of including a Twelve Step component with treatment. The program has an option for medically assisted treatment in conjunction with substance abuse counseling.

Visit http://4rbhaddictiontreatment.org to learn how to get help.

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