“This is my first child, and I don’t know what to do!” exclaimed Lyndsay, a newly pregnant individual, when I answered MotherToBaby’s free and confidential helpline. Lyndsay, who is in recovery from cocaine and opioid use disorder, expressed concern about the effects of her medications on her unborn child. Her regimen includes buprenorphine and naloxone for opioid use disorder, baclofen and n-acetylcysteine (NAC) for cocaine cravings, and aripiprazole, escitalopram, bupropion, and mirtazapine for depression, mood stabilization, and insomnia.
“This combination has been working well for me,” she explained, “but I wonder if the treatments are increasing my chances for pregnancy complications or birth defects in my baby?” Lyndsay considered discontinuing buprenorphine and naloxone.
To address her concerns, I consulted Ellen Kolomeyer, PhD, PMH-C, a licensed clinical psychologist certified in perinatal mental health, from the National Maternal Mental Health Hotline, which offers 24/7 support for pregnant and postpartum individuals experiencing mood and anxiety challenges.
Understanding Opioid Use Disorder Treatment During Pregnancy
According to the CDC, 7% of pregnant individuals use opioids during pregnancy, with one in five misusing them. However, only about half are in recovery, highlighting the importance of Lyndsay’s proactive approach to care. Her story emphasizes the possibility of maintaining health during pregnancy while managing opioid use disorder.
Common Treatments for Opioid Use Disorder
Healthcare providers typically prescribe methadone and buprenorphine to pregnant individuals dealing with opioid addiction. It is beneficial to start treatment before pregnancy to ensure the health of both mother and baby. Challenges such as emotional struggles, relationship issues, and societal stigma can impede access to treatment.
Discontinuing Treatment: Risks and Recommendations
Suddenly stopping opioid use during pregnancy can be hazardous. Managing opioid use with medication is safer and reduces the risk of relapse. Consulting with healthcare providers is essential before making any treatment changes.
Medication Management During Pregnancy
Pregnancy treatment plans vary; some individuals may need to start, stop, or switch medications. Providers often discuss options like methadone and buprenorphine and evaluate risks and benefits. It is crucial to work with knowledgeable healthcare providers to receive appropriate guidance.
Advocacy and Communication With Healthcare Providers
Pregnant individuals can face judgment but advocating for oneself is crucial. Understanding underlying challenges and discussing goals with providers can facilitate better care. Writing down questions before appointments and planning for labor, delivery, and postpartum care with providers can enhance communication and preparedness.
Post-Delivery Considerations
Newborns may experience withdrawal symptoms, known as neonatal abstinence syndrome, but this should not deter treatment. Collaboration with the baby’s healthcare provider is essential for monitoring and care. Preparing for potential NICU stays and advocating for bonding opportunities are important steps.
Resources and Support
A variety of free, confidential resources and programs are available to support pregnant individuals with opioid use disorder. Building a strong support system through support groups, counselors, and therapists can empower individuals in their recovery journey.
Lyndsay felt relieved knowing her treatment could support a healthy pregnancy and expressed newfound confidence in communicating with her healthcare providers. She realized she was not alone and had access to valuable resources.
Note: This information is educational and should not replace professional medical advice. Always consult with healthcare providers for personalized guidance.
