Any opioids -- even legal ones you get from your doctor -- can be harmful to you and your baby during pregnancy. Opioids include prescription painkillers, like codeine, hydrocodone (Lorcet, Vicodin), oxycodone (OxyContin, Percocet), and the illegal drug heroin. These drugs release chemicals in your brain that make you feel good. After you use them for a while, your body can become dependent on them. Then you may not be able to stop taking them. That’s called opioid use disorder. Your unborn baby can become dependent, too.
A lot of stigma surrounds opioid use. It can be hard to talk about, even with your doctor. But if you are pregnant, getting treatment for opioid dependence as soon as possible will give you a better chance of having a healthy pregnancy and a healthy baby.
Risks to You and Your Unborn Baby
When you take opioids, they pass through the placenta and reach your growing baby. These drugs can slow your baby's growth and cause problems like:
- Birth defects of the heart, belly, eyes, and spine
- Miscarriage or stillbirth
- Placental abruption, a serious complication that happens when the placenta separates from the wall of the uterus
- Early labor and birth
- Low birth weight
- Trouble breathing after birth
Opioid use during pregnancy can cause problems for you, too. You could develop preeclampsia. That’s high blood pressure combined with signs of organ damage, usually in the liver or kidneys. This can lead to serious illness, even death, for you and your baby.
Your baby may continue to struggle after birth. Neonatal abstinence syndrome (NAS) happens when babies become dependent on opioids in the womb. Once they're born, these babies have withdrawal symptoms such as:
Opioids indirectly affect your baby, too. When you take these drugs, you might not eat well or get the prenatal care you need to help your baby grow.
Some people who take opioids do unsafe things like having unprotected sex, which increases their risk for sexually transmitted diseases (STDs). Opioids also increase your risk for infections like HIV and hepatitis, which you can pass to your baby.
Talking to Your Doctor
If you've been taking opioids to manage pain, ask whether you can switch to a pain reliever that's safer during pregnancy. Your doctor will balance the need to treat your pain with the risks of taking these drugs. If you do take opioids, use the smallest dose possible for the shortest amount of time to manage your pain.
If you have opioid use disorder, see an OB/GYN and primary care doctor who have experience treating addiction. Or have an addiction specialist work with your other doctors to create a treatment plan for you.
Talking to your doctor about substance use can be scary. You might worry that you'll get arrested or that your baby will be taken away. Some states do consider substance abuse in pregnancy a crime, but they may go easier on pregnant women who get help. Share your concerns with a doctor you trust.
Which Opioid Addiction Treatments Are Safe During Pregnancy?
Even if you're ready to stop taking opioids, it's not safe to go off them suddenly during pregnancy. Quitting cold turkey could be very dangerous for your baby.
Opioid replacement therapy is a safer way to reduce your dependence on opioids. You take a different type of opioid to prevent withdrawal symptoms in both you and your baby. Because these drugs stay in your body for a long time, they safely reduce your need for opioids.
Opioid replacement therapy will lower your baby's risk for neonatal abstinence syndrome and keep you and your baby healthier during your pregnancy. It's a better option than a medically supervised withdrawal, or detox, program. After a detox program, you're more likely to have a relapse. That means you start using again.
Your doctor might also prescribe naloxone (Narcan). This medicine reverses the effects of opioids on your body. If you overdose, Narcan could save your life and your baby's life.
Therapy is another part of the treatment for opioid addiction. A drug counselor or therapist will help you find healthier ways to cope with challenges than by using drugs. Therapy also teaches you how to avoid situations that make you more likely to take opioids again.
Special Care During Pregnancy
Because of the effects opioid use can have on your body, your OB/GYN might recommend extra testing and special care during your pregnancy, including:
- Tests for STDs such as HIV, hepatitis B and C, gonorrhea, and syphilis
- Ultrasounds to check your baby's growth
- Screening and treatment for depression
- Screening for tobacco and other substance use
- Nutritional counseling
If you or a loved one needs help for opioid use disorder, talk to your doctor or call the Substance Abuse and Mental Health Services Administration's (SAMHSA's) National Helpline at 800-662-HELP.
