Opiate use in pregnancy is widespread. A study from 2007 found that almost 23% of pregnant women on Medicaid filled a prescription for an opiate during their pregnancy. Illegal opiate use is also thought to be common. Although it is hard to pinpoint how many heroin users are pregnant, about one-third of heroin users are female and 90% are of childbearing age.

Doctors usually advise women to avoid unneeded medications during pregnancy or while breastfeeding. For this reason, opiates are not usually the first choice for pain management while pregnant or breastfeeding. Doctors often advise women to explore other options so that the baby is not exposed to harmful substances. Alternatives to opiates include non-opiate drugs as well as non-drug therapies. A woman should always talk to their doctor before trying any therapy while pregnant or breastfeeding, whether they are drug or non-drug remedies. Some non-drug therapies for pain include:

  • Acupuncture
  • Biofeedback
  • Massage
  • Meditation
  • Physical therapy
  • Psychotherapy
  • Relaxation therapy

However, doctors know that certain medical issues may require pregnant or breastfeeding women to use opiates. In these cases, the benefit of opiate use is greater than the risk to the baby. Some health reasons to use opiates while pregnant or breastfeeding include:

  • The baby was delivered by cesarean section
  • Kidney stones
  • Sickle cell disease crisis
  • Traumatic injury during or after pregnancy
  • Medication-assisted treatment for substance use problems
  • Chronic pain that requires opiates for you to function

Effects of Using Opiates while Pregnant

If a woman uses opiates as directed by her doctor, opiate use is generally considered safe in pregnancy. Several studies looked at opiate safety in pregnancy, and overall, have found that the risk of harm is both rare and minimal.

However, if you take opiates that are not prescribed to you or in higher doses than prescribed, you and your baby may be in danger. Taking illegal opiate drugs like heroin while pregnant may also be very harmful. Complications of opiate misuse while pregnant include serious problems like:

  • Placenta separating from the uterus
  • Growth problems with the baby
  • Early birth
  • Stillbirth

However, women should not stop their opiate use abruptly, as doing so increases the chance of relapse. In turn, relapse only increases the risk to both you and your baby. Doctors estimate that suddenly stopping opiate use and going into withdrawal puts the risk of relapse over 90%. Instead, the doctor may be able to help the woman with medication-assisted treatment for opiate use.

If a woman utilizes medication-assisted treatment for opiates, such as with methadone or buprenorphine, doctors believe that the benefit outweighs the risk. Staying on the medication helps increase the chance that:

  • Women will have less risk of relapse
  • Women will avoid an early birth
  • The baby will grow healthily

Opiate Born Babies

Opiate-born babies are very common. In fact, in the United States, a baby with opiate withdrawal is born every 15 minutes.

Babies with opiates in their bodies at the time of birth may be diagnosed with neonatal abstinence syndrome (NAS). This condition can happen when a baby goes into opiate withdrawal from the opiates that their mother took during the pregnancy. Symptoms of NAS include:

  • Tremors
  • Seizures
  • Being fussy
  • Loose bowel movements
  • Throwing up
  • Poor feeding
  • Problems sleeping
  • A high-pitched cry

NAS can be treated. Mothers can comfort NAS babies with swaddling, cuddling and skin-to-skin contact. Sometimes, doctors prescribe opiates to babies with NAS. The babies are then slowly taken off the opiates until they are free of both opiates and NAS. Although NAS can occur in babies whose mothers take medication-assisted treatment for opiates, the severity of NAS is much less than if the mothers were misusing opiates.

Opiates and Breastfeeding

Many women who are on opiates can breastfeed. Doctors learned that women on opiates usually can breastfeed if they:

  • Are on stable doses of their opiate
  • Are not using illegal drugs like heroin
  • Have tested negative for human immunodeficiency virus, or HIV
  • Have no other medical reasons to not breastfeed

However, some opiates may be riskier than others for a baby. Specifically, if a mother takes codeine or tramadol, they should discuss the risks and benefits of these treatments with their doctor. These medications may put the baby at higher risk of opiate exposure. Additionally, women using street drugs like heroin, or who relapse into taking street drugs, can put their babies at risk of overdose if they breastfeed.

Key Points: Opiates, Pregnancy, and Breastfeeding

Important points to remember about opiates, pregnancy, and breastfeeding include:

  • Although most doctors try to avoid medication use in pregnancy, sometimes drugs like opiates are needed
  • Opiates are usually considered safe in pregnancy and breastfeeding if a woman takes them as prescribed
  • Medication-assisted treatment for pregnant women struggling with opiate use is recommended
  • If a mother takes opiates other than how they are prescribed, or if they use illegal opiates like heroin, the baby can be at risk if breastfed
  • Although babies whose mothers use opiates may be at risk for neonatal abstinence syndrome, this condition can be treated

If you struggle with opiate use and are considering pregnancy, help is available. Our professionals at The Recovery Village can assist you on your path to a healthier life. Contact The Recovery Village today to learn more.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.