Opioids During Pregnancy

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USING OPIOIDS DURING PREGNANCY: WHAT YOU NEED TO KNOW

This handout is to help you understand how to safely use opioids during pregnancy. Knowing your pain management options is important for your health and your baby’s well-being.

WHAT IS OPIOID USE DISORDER (OUD) DURING PREGNANCY?

Opioid Use Disorder is when someone uses opioids, like prescription painkillers or street drugs like heroin, while pregnant. This condition needs special care to keep both you and your baby safe and healthy.

WHAT TREATMENTS ARE AVAILABLE FOR OUD DURING PREGNANCY?

  1. If you use opioids during pregnancy, there are different ways to get help, such as: Medication for Opioid Use Disorder (MOUD) or Medication-Assisted Treatment (MAT): Your doctor may prescribe medications like methadone or buprenorphine (when combined with naloxone this is called Suboxone™) to help manage opioid dependence or pain.
  2. Counseling and Support Groups: Talking with therapists and social workers and joining support groups can help you cope with OUD and live a healthy lifestyle.
  1. If you use opioids during pregnancy, there are different ways to get help, such as: Medication for Opioid Use Disorder (MOUD) or Medication-Assisted Treatment (MAT): Your doctor may prescribe medications like methadone or buprenorphine (when combined with naloxone this is called Suboxone™) to help manage opioid dependence or pain.
  2. Counseling and Support Groups: Talking with therapists and social workers and joining support groups can help you cope with OUD and live a healthy lifestyle.

HOW CAN YOU TAKE CARE OF YOURSELF AND YOUR BABY?

  • Share your history with your healthcare team: Share all your medical history, including all prescribed and non-prescribed medications you are taking, with your doctor, anesthesiologist, and
    nurses. This will help them plan the best care for you and your baby.
  • Follow Medical Advice: Go to all your prenatal appointments and do what your healthcare provider suggests, like taking medications or making lifestyle changes.
  • Avoid Other Substance Use: Stay away from drugs or medicines not prescribed by your doctor.
  • Stay Healthy: Eat a balanced diet, exercise if your doctor says it’s okay, and get enough rest.

WHAT ABOUT PAIN DURING LABOR?

If you are worried about pain during labor because of your opioid use, talk to your healthcare team. They will help you make a plan that is safe for you and your baby. You might even meet with an anesthesiologist during the third trimester to create a pain management plan. Remember, pain can be managed effectively with careful planning, even with OUD.

CAN I KEEP TAKING METHADONE OR SUBOXONE AROUND DELIVERY?

Yes, it’s safe to continue taking methadone or buprenorphine as prescribed. Your healthcare team will make sure you get these medications while you are in the hospital.

CAN I HAVE AN EPIDURAL DURING LABOR?

Yes, you can have an epidural for pain relief during labor, even if you are taking medication for OUD. Make sure to tell your anesthesiologist about all the medications you are on.

ARE THERE OTHER OPTIONS BESIDES AN EPIDURAL?

If an epidural is not right for you, your healthcare team can talk to you about other options, like IV medications or inhaled nitrous oxide, depending on what’s available at your hospital.

WHAT IF I NEED A C-SECTION?

If you need a cesarean delivery (C-section), your healthcare team will plan to give you safe and effective pain relief. The most common approach is to use a spinal or epidural anesthesia that numbs the lower half of your body while you stay awake. Usually general anesthesia is not the first choice, but it depends on your medical history. Some options for pain control after surgery include nerve blocks to your abdomen or leaving an epidural catheter in your back for 24-48 hours after delivery so you can keep getting pain medication through the epidural. Non-opioid medications like ibuprofen/MotrinTM or acetaminophen/TylenolTM are also usually given to you after surgery.

WHAT IF I AM STILL IN PAIN AFTER DELIVERY?

If your pain isn’t well-controlled, tell your healthcare team. Everyone’s pain is different; they can adjust your medicines as needed. If you need extra medication, sometimes opioids, muscle relaxers, pain
patches, or other medications may be prescribed depending on your personal needs and history.

HOW WILL MY BABY BE MONITORED AFTER BIRTH?

Babies born to mothers who use opioids are closely watched for Neonatal Abstinence Syndrome (NAS), which is withdrawal symptoms from opioids after birth. Nurses and doctors will use different ways to help soothe your baby, and they may use a care method called “Eat/Sleep/Console” to help the baby feel better.

WHAT SHOULD I EXPECT AFTER DELIVERY?

After birth, your healthcare team will support you and your baby, making sure you are both healthy and safe. Follow the instructions they give you for care and call your doctor if you have any concerns.

WHERE CAN I FIND EXTRA SUPPORT?

You don’t have to go through this alone. Reach out to:

  1. Healthcare Providers: Your doctors and nurses are here to help you.
  2. Support Groups: Joining a support group or going to counseling can help you feel less alone.
  3. Therapy: Therapy can help you stay strong and manage any challenges you face.
  4. Family and Friends: Let trusted people support you during this time.

If you have any questions, don’t hesitate to ask your healthcare provider.

RESOURCES AND SUPPORT

  1. SAMHSA National Helpline: 1-800-662-4357
  2. Taylor M, Sorabella L. “Development of a Multimodal Pain Management Protocol for Parturients with
    OUD.” ASRA Pain Medicine News 2023;48.

This handout is meant to provide helpful information for anyone