When a pregnant woman uses heroin, there is a risk of premature birth, placental abruption, and low birth weight, but medication-assisted treatment can reduce harm.

Article at a Glance:

  • Every 15 minutes, a baby in the United States is born and suffers from opioid withdrawal.
  • Heroin use is associated with high-risk behaviors and poor prenatal care in pregnant women.
  • Babies born to pregnant women who are addicted to heroin are more likely to suffer from birth defects and heroin withdrawal upon birth.
  • The standard of care for the treatment of opioid addiction during pregnancy is medication-assisted treatment (MAT), which greatly reduces the risk of harm to the newborn.

Heroin and Pregnancy

Heroin is a powerful and addictive drug that can cause immense harm to the person using it, and if they’re pregnant, also to their unborn child.

The use of heroin is prevalent. In the 2019 National Survey on Drug Use and Health, 431,000 people in the U.S. ages 18 and over said they’d used heroin in the past month.

Almost half of all pregnancies in the U.S. are unintended, so it is possible that many pregnant women continue using heroin and opioids without even knowing they’re pregnant.

Effects Of Using Heroin During Pregnancy on the Mother

Using heroin may lead to unplanned pregnancies because of impaired decision-making skills and lack of access to birth control. Only around 56% of women with an opioid use disorder use contraception compared to 81% of women who don’t use drugs.

When you’re using heroin while pregnant, you might not be in the right state of mind to focus on the health and well-being of yourself or your child, including nutrition and general wellness. Women who use heroin while pregnant are at higher risk of violence, sexually transmitted diseases, participating in criminal activity, going to jail and losing custody of their child. Pregnant women with untreated heroin addiction are less likely to attend prenatal doctor visits as well.

Another problem, however, is that attempting to stop using heroin while pregnant can cause withdrawal. Withdrawal symptoms can include nausea, anxiety and depression. Withdrawal symptoms can lead women to relapse and use heroin again while pregnant.

Effects Of Heroin Use on the Unborn Baby

Chronic, untreated heroin use during pregnancy can cause serious or even deadly complications. However, it is important to understand that, with the appropriate use of prescription opioids, birth defects are extremely rare. Therefore, the established impacts to the fetus related to untreated heroin misuse are likely due to the repeated cycle of abuse and withdrawal, and other high-risk activities.

Other important points about heroin use on fetal development include:

  • Using heroin while pregnant could lead to congenital disabilities that can alter how a baby develops and affect their health for life.
  • Premature birth is more likely as well as low birth weight.
  • Placental abruption happens when the placenta separates from the uterine wall before birth and can be deadly for a mother and the baby.
  • Neonatal abstinence syndrome (NAS) happens when a baby is exposed to drugs in the womb and then is born experiencing withdrawal. Heroin withdrawal is generally not fatal for adults but can be fatal for newborns.

All of these possibilities are increased when a pregnant woman uses heroin.

Babies exposed to heroin during pregnancy are also more likely to experience sudden infant death syndrome (SIDS), which is the unexplained death of a baby that’s less than a year old.

Symptoms of Withdrawal in a Newborn Baby

Symptoms of NAS may include:

  • Blotchy Skin
  • Diarrhea
  • Excessive crying
  • Excessive sucking
  • Fever
  • Hyperactive reflexes
  • Increased muscle tone
  • Irritability
  • Poor feeding
  • Rapid breathing
  • Seizures
  • Sleep problems
  • Stuffy nose, sneezing
  • Sweating
  • Tremors
  • Vomiting

Heroin and Breastfeeding

If you are recovering from heroin and are stable on methadone or buprenorphine, it is usually fine for you to breastfeed. Very little of these drugs get to your baby through your breastmilk. Always consult with your doctor before beginning any new medication regimen, or altering an existing prescription.

However, there may be other health reasons your doctor has told you not to breastfeed, such as if you are actively using heroin or other opioids. The concern is that narcotics can go through your breastmilk and harm your baby. If you are on methadone and buprenorphine and resume heroin use, it is very important to not breastfeed until you talk to your doctor.

Finding Help for Heroin Use While Pregnant

Women who are pregnant and addicted to heroin are advised to first and foremost talk to their health care provider because quitting cold turkey can lead to complications as well.

The standard of care is called medication-assisted treatment (MAT) and may involve methadone or buprenorphine. These medications are also opioids, but they are safe to use during pregnancy under the supervision of an addiction specialist.

If you or a loved one live with addiction or are using drugs recreationally and want to stop, The Recovery Village can help. Reach out to one of our representatives today to learn how you can start on your path to recovery.

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By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more
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Editor – Erica Weiman
Erica Weiman graduated from Pace University in 2014 with a master's in Publishing and has been writing and editing ever since. Read more
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Medically Reviewed By – Dr. Kevin Wandler, MD
Kevin Wandler holds multiple positions at Advanced Recovery Systems. In addition to being the founding and chief medical director at Advanced Recovery Systems, he is also the medical director at The Recovery Village Ridgefield and at The Recovery Village Palmer Lake. Read more

American College of Obstetricians and Gynecologists. “Opioid Use and Opioid Use Disorder In Pregnancy.” August 2017. Accessed October 5, 2021.

Centers for Disease Control and Prevention. “Unintended Pregnancy.” June 2021. Accessed October 5, 2021.

Children’s Hospital of Philadelphia. “Illegal Drug Use and Pregnancy.”  Accessed October 5, 2021.

NIDA. “Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome.” National Institute on Drug Abuse, January 2019. Accessed October 21, 2021.

U.S. National Library of Medicine. “Opiate and Opioid Withdrawal.” MedlinePlus, June 2020. Accessed October 5, 2021.

U.S. National Library of Medicine. “Neonatal Abstinence Syndrome.” MedlinePlus, September 2019. Accessed October 5, 2021.

Substance Abuse and Mental Health Services Administration. “2019 National Survey of Drug Use and Health.” 2019. Accessed October 5, 2021.

Terplan, Mishka, et al. “Contraceptive use and method choice a[…]ystematic review.” Preventative Medicine, April 2016. Accessed October 5, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.