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Is Medication-Assisted Treatment Safe While Pregnant?

A pregnant woman talking to a doctor.

If you suspect that you may be pregnant and you are currently struggling with opioid addiction, it’s important to understand the effects of these drugs on an unborn child and the safest way to to prevent medical complications. With the rise of substance use disorders and opioid misuse in America, more and more people are at risk of the adverse effects of addiction, especially pregnant women. If you have found yourself in this situation, you are not alone. Breakthroughs in addiction science have made significant advancements in how we treat this disease. It’s possible for pregnant women to seek medication-assisted treatment, or MAT, to ensure their safety and the safety of their unborn child. MAT programs for expecting mothers with opioid addiction can help those in communities that have been hit hardest by the opioid epidemic, potentially saving many lives.

Opioid Use During Pregnancy

Using opioid medications, even if prescribed by a doctor, while pregnant can cause complications. It’s important for your doctor to know that you are pregnant and the stage of pregnancy you are at before they prescribe any medications. The potential risks opioid use could present to you and the baby include:

  • Miscarriage: Heavy opioid use during pregnancy has been known to cause the death of a baby in the womb before 20 weeks. Some miscarriages that occur later in the pregnancy have to be tended to medically and can be very traumatic.
  • Premature birth: Babies born before 37 weeks of pregnancy are considered to be premature and are susceptible to many dangerous health conditions. Opioids can cause preterm birth in those who use them regularly.
  • Congenital disabilities: Hearth defects, fetal growth restriction, and spina bifida are just some of the many critical health conditions babies can be born with if they are exposed to opioids in the womb. Spina bifida, specifically, is the most common and limits the development of the spinal cord and brain of the baby during stages of pregnancy.
  • Neonatal abstinence syndrome: NAS is when a baby is continually exposed to a drug while still in the womb and thus incurs withdrawal upon being born. When the mother takes opioids throughout pregnancy, NAS is most likely to occur, putting the baby in danger. Usually, babies with NAS are also born premature with low birth weight and breathing problems. Even with prescribed opioids babies can still be born with NAS. Be sure all of your doctors know that you are pregnant and what medications you have been prescribed.
  • Low Birthweight: Referred to as LBW is when a baby is born less than 5lbs, 8 ounces. LBW poses many health risks from diabetes to heart disease.

If you think you may be pregnant, speak to a doctor immediately to confirm. If you find out you are pregnant and want to continue with the pregnancy, it’s time to look into how  MAT works and which program is best for you.

MAT During Pregnancy

If you are pregnant and are currently addicted to opioids, do not stop using “cold turkey,” especially before you’ve talked to a doctor. Withdrawal is very harsh on the body and can significantly increase the chances of miscarriage. It can also lead to placental abruption, a serious condition where the placenta separates itself from the wall of the uterus which could lead to deadly consequences for the mother and baby. Quitting cold turkey can also cause preterm labor, growth problems for the baby, and even stillbirth.

The best course of action to take when ceasing the use of opioids during pregnancy is a medically assisted treatment with methadone or buprenorphine. These opioid treatments are “long-lasting” because they stay in your body for a long time in order to reduce your dependency on unregulated opioid use, especially heroin or other illicit drugs. While in MAT, it’s also important to speak with your doctor about a naloxone prescription in accidental cases of an overdose while pregnant. This nasal spray or shot should be with you at all times and is to be administered if you experience relapse and significant signs of an overdose. When taken in small doses, it is safe to use during pregnancy and can save both the mother and child from overdose.

Once the baby is born, the potential for NAS should be addressed right after birth. Mothers who are breastfeeding can help ease NAS symptoms in their babies and help boost their immune system. Due to the sometimes painful recovery process after giving birth, it’s not uncommon to be prescribed painkillers by an obstetrician. There are some painkillers that can be used safely, but not all. Unregulated opioid use outside of MAT after pregnancy during breastfeeding could pose serious consequences, so it’s very important to speak with your doctors if you may have experienced relapse shortly after giving birth. It is best to avoid possible relapse by avoiding taking any opioids outside of your MAT program.

When MAT is coupled with drug counseling, you have a higher chance to have a successful pregnancy without fatal complications. Both individual and group counseling can help you develop healthy habits and parenting skills that will help you adjust to life in recovery as a new parent. Because of the natural stressors of new parenthood, women who are new mothers while in recovery are sometimes prone to relapse. Parenting classes and counseling are essential to attend before the birth of the baby so that you can learn how to deal with the stressful days ahead. Being a new parent can be overwhelming, but also very rewarding and beautiful. Many expecting mothers in treatment have found their pregnancy and future child to be an inspiration during treatment that has helped them stay on the path towards long-lasting recovery.

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